NOELLE DOMINIQUE ALTAVILLA (RD, LDN) – Registered Dietitian, NPI 1275827008
Registered Dietitian
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for NOELLE DOMINIQUE ALTAVILLA (RD, LDN)
610 WYOMING AVE
KINGSTON, PA 187043702
Phone: (570) 288-5441
Type: Mailing
2 POPLAR ST
KINGSTON, PA 187043709
Phone: (570) 714-4090
Type: Location
2100 MACK BLVD FL 4
ALLENTOWN, PA 181035622
Phone: (484) 884-4500
Type: Mailing
2 Poplar St
Kingston, PA 187043709
Phone: (570) 714-4090
Type: Location
141 N VINE ST
HAZLETON, PA 182015852
Phone: (570) 501-6322
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: 2011-10-26
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 |
|---|---|---|---|---|
| I20111026000761 | I | Registered Dietitian Or Nutrition Professional | PA | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97802 | Therapy procedure for nutrition management, each 15 minutes | 40 | 27 | $0 |
| 97803 | Therapy procedure reassessment for nutrition management, each 15 minutes | 36 | 20 | $0 |
Insurance plans in this area (ZIP 18704)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | PA | |
| - | PA | |
| - | PA | |
| - | PA | |
| - | PA | |
| Internal Medicine | PA | |
| Family Practice | PA | |
| Nurse Practitioner | PA | |
| - | PA | |
| Internal Medicine | PA |
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