RDM PROFESSIONAL SERVICES, INC.
NPI 1699322867
Internal Medicine - Adolescent Medicine in Lake City, FL
About Rdm Professional Services, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RDM PROFESSIONAL SERVICES, INC. (NPI 1699322867) is a healthcare organization registered as an adolescent medicine in Lake City, Florida and active in the NPI registry since August 2019. The organization holds a CLIA Waiver certificate valid through June 5, 2027 and lists Rolando Dominguez Mustafa, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Rdm Professional Services, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Rdm Professional Services, Inc., which bills Medicare for the services they deliver. Of these, 1 practice at this address and 4 within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 10D2325099
Rdm Professional Services, Inc · Lake City, FLFrequently 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 Rdm Professional Services, Inc.'s NPI number?
The NPI number for Rdm Professional Services, Inc. is 1699322867. It was assigned to this organization in the NPPES registry on August 22, 2019.
Where is Rdm Professional Services, Inc. located?
Rdm Professional Services, Inc. is located at 777 W Duval St, Lake City, FL 32055. The listed phone number is (386) 755-3300.
What is Rdm Professional Services, Inc.'s specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Adolescent Medicine, with taxonomy code 207RA0000X.
Is Rdm Professional Services, Inc. enrolled in Medicare?
Yes. Rdm Professional Services, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Rdm Professional Services, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 3 Medicare specialties reassign their Medicare billing to Rdm Professional Services, Inc.. A 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 the clinician's services. The largest specialties are Nurse Practitioner (3), Emergency Medicine (1) and Hospitalist (1). Of these, 1 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Rdm Professional Services, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D2325099) is associated with this NPI, valid through June 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Rdm Professional Services, Inc. accept?
Health plans from Ambetter Health, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Rdm Professional Services, Inc. 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 Rdm Professional Services, Inc. was last updated on August 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Rdm Professional Services, Inc. · NPI 1699322867
Adolescent Medicine organization in Lake City, Florida. Organization record, active in the CMS NPPES registry since August 22, 2019.
## Identity
- **NPI:** 1699322867 (Entity type: Organization)
- **Enumerated:** August 22, 2019
- **Primary specialty:** Internal Medicine - Adolescent Medicine · taxonomy 207RA0000X
- **Organization subpart:** No
- **Authorized official:** Rolando Dominguez Mustafa, OWNER
## Practice location
- **Address:** 777 W DUVAL ST, Lake City, FL 32055-5806
- **Phone:** (386) 755-3300 · **Fax:** (386) 935-4331
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Emergency Medicine (1), Hospitalist (1); 1 practice at this address and 4 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 29, 2025
- **Other identifiers:** Medicaid 015321200 (FL)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1699322867) · Data from the CMS NPPES public registry.