1. Home
  2. Directory
  3. New York
  4. Brooklyn
  5. Dietitian Registered
  6. NPI Profile

FULLY FUNCTIONAL NUTRITION WELLNESS PLLC
NPI 1831920131
Dietitian, Registered in Brooklyn, NY

Active since August 09, 2024
1419 E 9TH ST, BROOKLYN, NY 11230(917) 717-0146(848) 674-0001 Get Directions Write a Review

NPPES record last updated: August 9, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Fully Functional Nutrition Wellness Pllc NPPES

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

FULLY FUNCTIONAL NUTRITION WELLNESS PLLC (NPI 1831920131) is a healthcare organization registered as a dietitian, registered in Brooklyn, New York and active in the NPI registry since August 2024. The organization lists Dalia Harush, Owner, as its authorized official.

NPPES Registry Identity

NPI1831920131
Entity TypeOrganization
Primary Taxonomy133V00000X
Legal Business NameFULLY FUNCTIONAL NUTRITION WELLNESS PLLC
Location Address1419 E 9TH STBrooklyn, NY 11230-6459
Mailing Address1419 E 9th StBrooklyn, NY 11230-6459 · (917) 717-0146 · Fax (848) 674-0001
Phone(917) 717-0146
Fax(848) 674-0001
Organization SubpartNo
Authorized OfficialDalia HarushOwner · (732) 710-7915
Enumeration DateAugust 9, 2024
NPPES CertifiedAugust 9, 2024
✔ NPI 1831920131 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
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.
1419 E 9TH ST, Brooklyn, NY 11230
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fully Functional Nutrition Wellness Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Fully Functional Nutrition Wellness PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Dalia Harush, RDN
Registered Dietitian or Nutrition Professional
NPI 1619670726
1419 E 9TH ST
Brooklyn, NY 11230
(732) 710-7915
Same address

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 Fully Functional Nutrition Wellness PLLC's NPI number?

The NPI number for Fully Functional Nutrition Wellness PLLC is 1831920131. It was assigned to this organization in the NPPES registry on August 9, 2024.

Where is Fully Functional Nutrition Wellness PLLC located?

Fully Functional Nutrition Wellness PLLC is located at 1419 E 9th St, Brooklyn, NY 11230. The listed phone number is (917) 717-0146.

What is Fully Functional Nutrition Wellness PLLC's specialty?

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

Is Fully Functional Nutrition Wellness PLLC enrolled in Medicare?

Yes. Fully Functional Nutrition Wellness PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Fully Functional Nutrition Wellness PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Registered Dietitian or Nutrition Professional) reassigns their Medicare billing to Fully Functional Nutrition Wellness PLLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Fully Functional Nutrition Wellness PLLC was last updated on August 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.