Brinsley Joallen Kubiak, MS, RDN, LDN
NPI 1457031551ActiveIndividual· Dietitian, Registered· Chicago, IL
Dietitian, Registered (MS, RDN, LDN) with Revolution Ptwl LLC, practicing in Chicago, Illinois. Enrolled in Medicare as practitioner - registered dietitian or nutrition professional.
Overview
| NPI | 1457031551 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MS, RDN, LDN |
| Sole proprietor | Yes |
| NPI issued | Jul 24, 2023 |
| Last updated in NPPES | Jul 24, 2023 |
| Certified by provider | Jul 23, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | 86153070 | MI |
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 (IL) |
|---|
Education and affiliations
| Graduation year | 2020 |
|---|---|
| Medicare specialty | Registered Dietitian Or Nutrition Professional |
Medical group
- Revolution Ptwl LLCChicago, IL · 43 clinicians
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