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NOELLE DOMINIQUE ALTAVILLA RD, LDN
NPI 1275827008
Dietitian, Registered in Hazleton, PA

Active since June 09, 2011
90.34/100
CMS Quality Rating
141 N VINE ST, HAZLETON, PA 18201(570) 501-6322 Get Directions Write a Review

NPPES record last updated: August 21, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 21, 2023, Jul 26, 2021 (2 updates tracked since 2021).

About Noelle Dominique Altavilla Rd, Ldn NPPES

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

NOELLE DOMINIQUE ALTAVILLA RD, LDN (NPI 1275827008) is an individual dietitian, registered in Hazleton, Pennsylvania, licensed in Pennsylvania (DN003742) and active in the NPI registry since June 2011. She maintains a secondary practice location in Kingston.

NPPES Registry Identity

NPI1275827008
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameNOELLE DOMINIQUE ALTAVILLACredential: RD, LDN
Location Address141 N VINE STHazleton, PA 18201-5852
Mailing Address2100 Mack Blvd Fl 4Allentown, PA 18103-5622 · (484) 884-4500
Phone(570) 501-6322
Sole ProprietorNo
Enumeration DateJune 9, 2011
Last NPPES UpdateAugust 21, 20232 updates tracked since enumeration
NPPES CertifiedAugust 21, 2023
✔ NPI 1275827008 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in PA · DN003742
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.
Also ListedNutritionistTaxonomy 133N00000X
141 N VINE ST, Hazleton, PA 18201
Open in Google Maps ↗

Secondary Practice Location 1

Location 12 Poplar StKingston, PA 18704-3709 · Phone (570) 714-4090

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Noelle Dominique Altavilla Rd, Ldn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignments

3

Medicare enrollment records show Noelle Altavilla reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lehigh Valley Physician Group
Same address
Family Medicine
141 N VINE ST
Hazleton, PA 18201
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 2,895 clinicians in this Medicare group
NPI 1558125997 (570) 454-0500
Lehigh Valley Physician Group
0.5 mi
General Practice
564 W BROAD ST, SUITE 2
Hazleton, PA 18201
  • Reassigned Medicare billing, Pennsylvania enrollment
  • Medicare enrollment name: Hazleton Professional Services
  • 305 clinicians in this Medicare group
NPI 1942609599 (570) 501-6220
Commonwealth Physician Network LLC
22 mi
Internal Medicine
610 WYOMING AVE
Kingston, PA 18704
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 73 clinicians in this Medicare group
NPI 1003238635 (570) 288-5441

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

90.34/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.69
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 8

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

LAURA MONTO RD
Dietitian, Registered
141 N VINE ST
HAZLETON, PA 18201
Luzerne County (570) 454-0500
CARDIOLOGY ASSOCIATES OF GREATER HAZLETON PC
Internal Medicine (Cardiovascular Disease)
141 N VINE ST
HAZLETON, PA 18201
Luzerne County (570) 454-2467
LEHIGH VALLEY PHYSICIAN GROUP
Family Medicine
141 N VINE ST
HAZLETON, PA 18201
Luzerne County (570) 454-0500
CHRISTINE RITA WYSOCKY
Nurse Practitioner (Family)
141 N VINE ST
HAZLETON, PA 18201
Luzerne County (570) 454-0500
DR. TEQUILLA TAVOCKIOUS AYINLA MD
Family Medicine
141 N VINE ST
HAZLETON, PA 18201
Luzerne County (570) 454-0500
YALIXSA THEN FNP-BC
Nurse Practitioner (Family)
141 N VINE ST
HAZLETON, PA 18201
Luzerne County (570) 454-0500
THOMAS J CIOTOLA MD
Internal Medicine (Cardiovascular Disease)
141 N VINE ST
HAZLETON, PA 18201
Luzerne County (570) 454-2467
CHANDRA M MOHAN MD
Internal Medicine (Cardiovascular Disease)
141 N VINE ST
HAZLETON, PA 18201
Luzerne County (570) 454-2467

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 Noelle Altavilla's NPI number?

The NPI number for Noelle Altavilla is 1275827008. It was assigned to this individual provider in the NPPES registry on June 9, 2011.

Where is Noelle Altavilla located?

Noelle Altavilla practices at 141 N Vine St, Hazleton, PA 18201. The listed phone number is (570) 501-6322.

What is Noelle Altavilla's specialty?

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

Is Noelle Altavilla enrolled in Medicare?

Yes. Noelle Altavilla is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Noelle Altavilla's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Noelle Altavilla reassigns Medicare benefits to 3 organizations: Lehigh Valley Physician Group (Hazleton, PA), Lehigh Valley Physician Group (Hazleton, PA) and Commonwealth Physician Network LLC (Kingston, PA). Each 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 Noelle Altavilla'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 Noelle Altavilla was last updated on August 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.