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NICOLE SAMANTHA SARES
NPI 1164993978
Dietitian, Registered in Ashtabula, OH

Active since December 06, 2018
3225 LAKE AVE, ASHTABULA, OH 44004(440) 998-7515(440) 998-0973 Get Directions Write a Review

NPPES record last updated: December 6, 2018. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Nicole Samantha Sares NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE SAMANTHA SARES (NPI 1164993978) is an individual dietitian, registered in Ashtabula, Ohio, licensed in Illinois (1049341) and active in the NPI registry since December 2018. She is a graduate of Other (2011).

NPPES Registry Identity

NPI1164993978
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameNICOLE SAMANTHA SARES
Location Address3225 LAKE AVEAshtabula, OH 44004-5758
Mailing Address3225 Lake AveAshtabula, OH 44004-5758 · (440) 998-7515 · Fax (440) 998-0973
Phone(440) 998-7515
Fax(440) 998-0973
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateDecember 6, 2018
✔ NPI 1164993978 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
Licenses✔ Licensed in IL · 1049341✔ Licensed in OH · LD.6996
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
3225 LAKE AVE, Ashtabula, OH 44004
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Samantha Sares is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5294205308
PECOS Enrollment IDI20260529003466

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ADRIANNA VOLPI CDCA
Counselor (Addiction (Substance Use Disorder))
3225 LAKE AVE
ASHTABULA, OH 44004
Ashtabula County (440) 650-5030
MRS. SHERRY LYN SNITCHER R.N. IBCLC
Registered Nurse (Lactation Consultant)
3225 LAKE AVE
ASHTABULA, OH 44004
Ashtabula County (440) 998-7515

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 Nicole Sares's NPI number?

The NPI number for Nicole Sares is 1164993978. It was assigned to this individual provider in the NPPES registry on December 6, 2018.

Where is Nicole Sares located?

Nicole Sares practices at 3225 Lake Ave, Ashtabula, OH 44004. The listed phone number is (440) 998-7515.

What is Nicole Sares's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Nicole Sares enrolled in Medicare?

Yes. Nicole Sares is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nicole Sares was last updated on December 6, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.