Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Michelle Dominguez Medina

Individual provider Pediatric Nutrition Registered Dietitian · NPI 1255283669

Michelle Dominguez Medina is a Registered Dietitian OR Nutrition Professional in Providence, Rhode Island. Qualified in 2025, 1 year ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
1
Licensed in
RI
In the registry since
2026
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

593 Eddy St
Providence, RI 02903-4923
Phone: (401) 444-5603
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nutrition Registered Dietitian (primary) Taxonomy 133VN1004X · Licence LDN01639 (RI)

Record details

NPI number1255283669
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedFebruary 10, 2026
Last updated in NPPESFebruary 10, 2026
Certification dateFebruary 10, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Providence