Kelly Danielle Tahlor, RDN, CDN
NPI 1275231433ActiveIndividual· Dietitian, Registered· Centereach, NY
Dietitian, Registered (RDN, CDN) with Stony Brook Surgical Associates University Faculty Practice Corporati, practicing in Centereach, New York. Enrolled in Medicare as practitioner - registered dietitian or nutrition professional.
Overview
| NPI | 1275231433 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | RDN, CDN |
| Sole proprietor | No |
| NPI issued | Feb 17, 2023 |
| Last updated in NPPES | Feb 17, 2023 |
| Certified by provider | Dec 6, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | 011259 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Registered Dietitian Or Nutrition Professional (NY) |
|---|
Education and affiliations
| Graduation year | 2021 |
|---|---|
| Medicare specialty | Registered Dietitian Or Nutrition Professional |
| Telehealth | Offers telehealth |
Medical group
- Stony Brook Surgical Associates University Faculty Practice CorporatiHampton Bays, NY · 109 clinicians
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