Individual provider Active NPI

Lauren Degaetano, CDN

  • Metabolic Nutrition Registered Dietitian
  • New York, NY
National Provider Identifier
1982976684
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
License
006896-1 Issued in NY
Practice address
215 E 95TH St
New York, NY 10128-4077
Phone
(121) 299-6800
Fax
(121) 242-3312
NPI assigned
Jan 27, 2012
Last updated
Jan 2, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X 006896-1 NY Primary

Addresses

Primary practice location

215 E 95TH St
New York, NY 10128-4077

Mailing address

215 E 95TH St
New York, NY 10128-4077
Phone (121) 299-6800

Other names 1

  • Ms. Lauren Mirro Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120411000095 NY Practitioner - Registered Dietitian Or Nutrition Professional 9133380686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Dietetics and Nutrition PLLCGroup PAC ID 8224563929, 13 clinicians

Practice addresses (Care Compare)

358 Veterans Memorial Hwy
Suite 10
Commack, NY 11725-4326
Phone (516) 441-9013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006896-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York Dietetics and Nutrition PLLC CurrentSince Dec 1, 2024 Accepting new patients
Foodandfitnesspro, LLC Current Accepting new patients
LHHN Medical, P.C. Past Accepting new patients

Locations

157 Church St
New Haven, CT 06510
Phone (203) 479-0473

358 Veterans Memorial Hwy
Ste 10
Commack, NY 11725
Phone (516) 441-9013

400 S Oyster Bay Rd
Ste 300
Hicksville, NY 11801
Phone (215) 776-0389

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1982976684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E 95TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101284077",
            "telephone_number": "121-299-6800",
            "fax_number": "121-242-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E 95TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101284077",
            "telephone_number": "121-299-6800",
            "fax_number": "121-242-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGAETANO",
        "first_name": "LAUREN",
        "name_prefix": "Mrs.",
        "credential": "CDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-27",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "NY",
            "license": "006896-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "MIRRO",
            "prefix": "MS.",
            "credential": "CDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; 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.