WILLIAM N CIVITILLO MS RD RDN
NPI 1114670338
Dietitian, Registered in Whitestone, NY
About William N Civitillo Ms Rd Rdn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WILLIAM N CIVITILLO MS RD RDN (NPI 1114670338) is an individual dietitian, registered in Whitestone, New York, licensed in New York (86109420) and active in the NPI registry since January 2022. He is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
William N Civitillo Ms Rd Rdn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show William Civitillo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Elmont, NY 11003
- Reassigned Medicare billing, New York enrollment
- Medicare enrollment name: Nassau Health Care Corporation
- 553 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is William Civitillo's NPI number?
The NPI number for William Civitillo is 1114670338. It was assigned to this individual provider in the NPPES registry on January 28, 2022.
Where is William Civitillo located?
William Civitillo practices at 1502 146th St, Whitestone, NY 11357. The listed phone number is (718) 309-8718.
What is William Civitillo's specialty?
The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.
Is William Civitillo enrolled in Medicare?
Yes. William Civitillo is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for William Civitillo's services?
According to the CMS Revalidation Reassignment List (October 2026 release), William Civitillo reassigns Medicare benefits to Elmont Community Health Center (Elmont, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for William Civitillo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for William Civitillo was last updated on January 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# William N Civitillo, MS RD RDN · NPI 1114670338
Dietitian, Registered provider in Whitestone, New York. Individual provider, active in the CMS NPPES registry since January 28, 2022.
## Identity
- **NPI:** 1114670338 (Entity type: Individual)
- **Enumerated:** January 28, 2022
- **Primary specialty:** Dietitian, Registered · taxonomy 133V00000X
- **State license:** 86109420 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1502 146TH ST, Whitestone, NY 11357-3019
- **Phone:** (718) 309-8718
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Elmont Community Health Center (NPI 1467478362, Elmont, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** January 28, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1114670338) · Data from the CMS NPPES public registry.