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TESSA KOMINE MS, RDN, LD, CD
NPI 1396295580
Dietitian, Registered in Portland, OR

Active since October 11, 2016Opted out of Medicare · through Jan 1, 2028
2100 NE BROADWAY ST STE 225, PORTLAND, OR 97232(971) 270-0590(971) 255-1754 Get Directions Write a Review

NPPES record last updated: October 21, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 21, 2019, Apr 25, 2018, Oct 11, 2016 (3 updates tracked since 2016).

About Tessa Komine Ms, Rdn, Ld, Cd NPPES

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

TESSA KOMINE MS, RDN, LD, CD (NPI 1396295580) is an individual dietitian, registered in Portland, Oregon, licensed in Oregon (LD-D-10188211) and active in the NPI registry since October 2016. She has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1396295580
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameTESSA KOMINECredential: MS, RDN, LD, CD
Location Address2100 NE BROADWAY ST STE 225Portland, OR 97232
Mailing Address2100 Ne Broadway St Ste 225Portland, OR 97232-1544 · (971) 270-0590 · Fax (971) 255-1754
Phone(971) 270-0590
Fax(971) 255-1754
Sole ProprietorNo
Enumeration DateOctober 11, 2016
Last NPPES UpdateOctober 21, 20193 updates tracked since enumeration
✔ NPI 1396295580 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in OR · LD-D-10188211
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.
2100 NE BROADWAY ST STE 225, Portland, OR 97232
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Regence BlueCross BlueShield of Oregon.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Tessa Komine Ms, Rdn, Ld, Cd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2020 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2020
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 11

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

FEARLESS WITH FOOD, LLC
Dietitian, Registered
2100 NE BROADWAY ST STE 225
PORTLAND, OR 97232
Multnomah County (971) 270-0590
DR. CASEY ELIZABETH CARPENTER N.D., LAC
Naturopath
2100 NE BROADWAY ST STE 225
PORTLAND, OR 97232
Multnomah County (971) 405-0583
CHELSEA KRISANDA LAC
Acupuncturist
2100 NE BROADWAY ST STE 225
PORTLAND, OR 97232
Multnomah County (503) 719-5000
DANIELLE ALLEN LMT
Massage Therapist
2100 NE BROADWAY ST STE 225
PORTLAND, OR 97232
Multnomah County (503) 719-5000
ZOCALO WELLNESS, LLC
Clinic/Center
2100 NE BROADWAY ST STE 225
PORTLAND, OR 97232
Multnomah County (503) 724-4321
CLARKE MOREFIELD LMT
Massage Therapist
2100 NE BROADWAY ST STE 225
PORTLAND, OR 97232
Multnomah County (503) 719-5000
LAURA HOLTHAUSEN LMT
Massage Therapist
2100 NE BROADWAY ST STE 225
PORTLAND, OR 97232
Multnomah County (503) 719-5000
PHOEBE GERAGHTY
Massage Therapist
2100 NE BROADWAY ST STE 225
PORTLAND, OR 97232
Multnomah County (503) 719-5000

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 Tessa Komine's NPI number?

The NPI number for Tessa Komine is 1396295580. It was assigned to this individual provider in the NPPES registry on October 11, 2016.

Where is Tessa Komine located?

Tessa Komine practices at 2100 NE Broadway St Ste 225, Portland, OR 97232. The listed phone number is (971) 270-0590.

What is Tessa Komine's specialty?

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

Is Tessa Komine enrolled in Medicare?

No. Tessa Komine has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Tessa Komine accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc. and Regence BlueCross BlueShield of Oregon list Tessa Komine as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tessa Komine was last updated on October 21, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.