MS. BONNIE LYNN BERUBE (MS, RD, LD) – Registered Dietitian, NPI 1275802803

MS. BONNIE LYNN BERUBE (MS, RD, LD) is a healthcare provider. based in Houston, Texas. specializing in REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL. They hold the professional credentials MS, RD, LD. They hold a License No. DT00673 (TX). The NPI Number for MS. BONNIE LYNN BERUBE (MS, RD, LD) is 1275802803

Main info

Female
Sole Proprietor
40 Years Of Experience
Accepts Medicare Assignment
Name
MS. BONNIE LYNN BERUBE (MS, RD, LD)
NPI
1275802803
Phone
(713) 785-6481
Address
1425 BLALOCK RD
Enumeration Date
28 December 2011
Last Update Date
28 December 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4138622563
Graduation Year
1986 (40 years ago)
PAC ID
8921274283
Group Practice PAC ID
6608093455
Professional Enrollment ID
I20120109000327
Address ID
TX774501571KA460XXDRXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

529 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in TX

Provider Addresses for MS. BONNIE LYNN BERUBE (MS, RD, LD)

  • 1425 BLALOCK RD

    SUITE 107

    HOUSTON, TX 770554475

    Phone: (713) 785-6481

    Fax: (713) 785-7200

    Mailing address matches the actual address.

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: 2012-01-09

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120109000327IRegistered Dietitian Or Nutrition ProfessionalTXTBD

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.

Verify on CMS Revalidation Lookup Tool

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 77055)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6608093455View full group profile
NameSpecialtyState
General PracticeTX
Family PracticeTX
P S Y C H I A T R YCO

Reviews

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Frequently asked questions

What number should I use to identify MS. BONNIE LYNN BERUBE (MS, RD, LD) for billing?
Administrative and clinical systems typically use NPI 1275802803 for MS. BONNIE LYNN BERUBE (MS, RD, LD).
Does the public listing show MS. BONNIE LYNN BERUBE (MS, RD, LD) as active?
MS. BONNIE LYNN BERUBE (MS, RD, LD)'s NPI record reflects an active status in NPPES.
What services align with MS. BONNIE LYNN BERUBE (MS, RD, LD)'s listing?
MS. BONNIE LYNN BERUBE (MS, RD, LD)'s public classification highlights Registered Dietitian. Clinical services aligned with this taxonomy classification.
Is MS. BONNIE LYNN BERUBE (MS, RD, LD) tied to Houston, Texas?
If you are local to Houston, Texas, MS. BONNIE LYNN BERUBE (MS, RD, LD) may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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