MARLA JOY MUNGOVAN (RD LDN) – Nutritionist, NPI 1245807189
Nutritionist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
247 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in MA
Provider Addresses for MARLA JOY MUNGOVAN (RD LDN)
PO BOX 415348
BOSTON, MA 022415348
Phone: (800) 225-8885
Fax: (508) 334-1977
Type: Mailing
55 LAKE AVE N
WORCESTER, MA 016550002
Phone: (747) 443-2491
Type: Location
48 LAKE ST
SPENCER, MA 015621828
Phone: (860) 614-0305
Type: Mailing
35 TURKEY HILL RD STE 201D
BELCHERTOWN, MA 010079032
Phone: (413) 658-8590
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-11-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20221117003350 | I | Registered Dietitian Or Nutrition Professional | MA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 02241)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | MA | |
| - | MA | |
| - | MA | |
| Family Practice | MA | |
| Physician Assistant | MA | |
| Pulmonary Disease, Critical Care (Intensivists), Allergy/Immunology | MA | |
| - | MA | |
| - | MA | |
| Internal Medicine | MA | |
| Nurse Practitioner | MA |
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