MICHELLE DOMINGUEZ MEDINA
NPI 1255283669
Dietitian, Registered - Nutrition, Pediatric in Providence, RI

Q: What is Michelle Dominguez Medina's NPI number?

The NPI number for Michelle Dominguez Medina is 1255283669. It was assigned to this individual provider in the NPPES registry on February 10, 2026.

Q: What is Michelle Dominguez Medina's specialty?

The primary specialty registered for this NPI is Dietitian, Registered, specializing in Nutrition, Pediatric, with taxonomy code 133VN1004X.

Active since February 10, 2026Accepts Medicare Assignment

593 EDDY ST, PROVIDENCE, RI 02903(401) 444-5603 Get Directions Write a Review

NPPES record last updated: February 10, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Michelle Dominguez Medina NPPES

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

MICHELLE DOMINGUEZ MEDINA (NPI 1255283669) is an individual nutrition, pediatric provider in Providence, Rhode Island, licensed in Rhode Island (LDN01639) and active in the NPI registry since February 2026. She is a graduate of Other (2025).

NPPES Registry Identity

NPI1255283669

Entity TypeIndividualFemale

Primary Taxonomy133VN1004X

Provider Legal NameMICHELLE DOMINGUEZ MEDINA

Location Address593 EDDY STProvidence, RI 02903-4923

Mailing Address593 Eddy StProvidence, RI 02903-4923 · (401) 444-5603

Phone(401) 444-5603

Sole ProprietorYes

Medical School CMSOtherGraduated 2025

Enumeration DateFebruary 10, 2026

NPPES CertifiedFebruary 10, 2026

✔ NPI 1255283669 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, Registered · Nutrition, PediatricDietary & Nutritional Service Providers

Taxonomy Code133VN1004X

License✔ Licensed in RI · LDN01639

Definition

An individual who is a Board Certified Specialist in Pediatric Nutrition and applies evidence-based nutrition knowledge in providing medical nutrition therapy for pediatric patients. Specialists work directly with healthy and/or ill children (newborn up to 21 years of age) as well as children with special health care needs in a variety of settings (hospitals, community-based and/or family-centered programs, education programs, home, etc.), OR indirectly through management, care coordination, education, quality improvement, or research practice linked specifically to pediatric nutrition.

593 EDDY ST, Providence, RI 02903

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michelle Dominguez Medina is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4082180542

PECOS Enrollment IDI20260421003516

Medicare Billing Reassignment

Medicare enrollment records show Michelle Dominguez Medina reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Rhode Island Hospital

Same address

Pediatrics

593 EDDY ST
Providence, RI 02903

Reassigned Medicare billing, Rhode Island enrollment
265 clinicians in this Medicare group

NPI 1861420333 (401) 444-6195

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

Other Providers at the Same Location NPPES 20

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

DR. KEITH-AUSTIN SCARFO D.O.

Anesthesiology

593 EDDY ST, APC 6
PROVIDENCE, RI 02903

Providence County (401) 444-3777

AILEEN HSUEH

Surgery

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 444-8450

RHODE ISLAND HOSPITAL

General Acute Care Hospital

593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903

Providence County (401) 444-7585

DR. GA HIE NAM M.D.

Pathology (Anatomic Pathology & Clinical Pathology)

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 444-5057

EUGENIE ATALLAH

Psychiatry & Neurology (Neurology)

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 606-2645

BRET CAULFIELD

Physician Assistant

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 444-4000

JUNG HO GONG

Student in an Organized Health Care Education/Training Program

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 793-2695

FANNY HUANG MD

Student in an Organized Health Care Education/Training Program

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 444-4741

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 Michelle Dominguez Medina's NPI number?

The NPI number for Michelle Dominguez Medina is 1255283669. It was assigned to this individual provider in the NPPES registry on February 10, 2026.

Where is Michelle Dominguez Medina located?

Michelle Dominguez Medina practices at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 444-5603.

What is Michelle Dominguez Medina's specialty?

The primary specialty registered for this NPI is Dietitian, Registered, specializing in Nutrition, Pediatric, with taxonomy code 133VN1004X.

Is Michelle Dominguez Medina enrolled in Medicare?

Yes. Michelle Dominguez Medina is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Michelle Dominguez Medina's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michelle Dominguez Medina reassigns Medicare benefits to Rhode Island Hospital (Providence, RI). The 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 Michelle Dominguez Medina'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 Michelle Dominguez Medina was last updated on February 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.