Individual provider Active NPI

Evelyn Duran - Ponce, RD, CDE

  • Metabolic Nutrition Registered Dietitian
  • Smithtown, NY
National Provider Identifier
1982848537
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
License
855320 Issued in NY
Practice address
732 Smithtown Byp 103
Smithtown, NY 11787-5020
Phone
(631) 265-5545
Fax
(631) 265-8042
NPI assigned
Apr 27, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X 005188-1 NY
Metabolic Nutrition Registered Dietitian 133VN1006X 855320 NY Primary

Addresses

Primary practice location

732 Smithtown Byp 103
Smithtown, NY 11787-5020

Mailing address

732 Smithtown Byp Ste 103
Smithtown, NY 11787-5020
Phone (631) 265-5545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100820000671 NY Practitioner - Registered Dietitian Or Nutrition Professional 3476687864 Practice locations: Smithtown, NY

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

732 Smithtown Byp
Smithtown, NY 11787-5020
Phone (631) 265-2375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
855320NYMDMetabolic Nutrition Registered Dietitian
005188-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Middle Country Endocrinology, PC PastSince Nov 1, 2009 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJCEAD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1982848537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 SMITHTOWN BYP STE 103",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875020",
            "telephone_number": "631-265-5545",
            "fax_number": "631-265-8042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 SMITHTOWN BYP 103",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875020",
            "telephone_number": "631-265-5545",
            "fax_number": "631-265-8042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURAN - PONCE",
        "first_name": "EVELYN",
        "name_prefix": "Mrs.",
        "credential": "RD,  CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-27",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NY",
            "license": "005188-1",
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "NY",
            "license": "855320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.