Individual provider Active NPI

Mariane Domingos, RD

  • Registered Dietitian
  • Norwich, NY
National Provider Identifier
1063375285
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
012321 Issued in NY
Practice address
188 Canasawacta Ter
Norwich, NY 13815-3606
Phone
(680) 287-1927
NPI assigned
Dec 4, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 012321 NY Primary

Addresses

Primary practice location

188 Canasawacta Ter
Norwich, NY 13815-3606

Mailing address

188 Canasawacta Ter
Norwich, NY 13815-3606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
012321NYMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1764806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1063375285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 CANASAWACTA TER",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "138153606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 CANASAWACTA TER",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "138153606",
            "telephone_number": "680-287-1927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGOS",
        "first_name": "MARIANE",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-04",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "012321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.