Individual provider Active NPI

Tanya Kay Solberg, MS, RD, LDN, CDOE

  • Registered Dietitian
  • Pawtucket, RI
National Provider Identifier
1063422673
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LDN00452 Issued in RI
Practice address
727 East Ave
Pawtucket, RI 02860-6185
Phone
(401) 725-6160
Fax
(401) 722-5430
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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 LDN00452 RI Primary

Addresses

Primary practice location

727 East Ave
Pawtucket, RI 02860-6185

Mailing address

10 Davol SQ
Suite 400
Providence, RI 02903-4754
Phone (401) 421-4000

Other identifiers 5

IdentifierTypeStateIssuer
6400144OtherRIPT/OT UHP NUMBER
ES01788MedicaidRI
2092OtherRIEI NHPRC NUMBER
412296OtherRIEI BCHIP NUMBER
292177OtherRIEI BLUE CROSS NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tsolberg220886@direct.lifespan.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110711000040 RI Practitioner - Registered Dietitian Or Nutrition Professional 4183802424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Medical Physicians IncGroup PAC ID 0345658316, 222 clinicians

Practice addresses (Care Compare)

727 E Ave
Pawtucket, RI 02860-6185
Phone (401) 725-6160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Physicians, Inc. Dietitian, Registered CurrentSince Apr 25, 2021 Accepting new patients
Coastal Medical Physicians, Inc. CurrentSince Apr 25, 2021 Accepting new patients
Diabetes Education Partners of Rhode Island CurrentSince Dec 8, 2018 Accepting new patients
Meeting Street Center Past Accepting new patients
Coastal Medical, Inc. Past Accepting new patients
Hillside Family and Community Medicine, LLC Past Accepting new patients

Locations

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

727 East Ave
Pawtucket, RI 02860
Phone (401) 724-6800

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1063422673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DAVOL SQ",
            "address_2": "SUITE 400",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034754",
            "telephone_number": "401-421-4000",
            "fax_number": "401-272-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 EAST AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028606185",
            "telephone_number": "401-725-6160",
            "fax_number": "401-722-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLBERG",
        "first_name": "TANYA",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "MS, RD, LDN, CDOE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "RI",
            "license": "LDN00452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT/OT UHP NUMBER",
            "identifier": "6400144",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ES01788",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EI NHPRC NUMBER",
            "identifier": "2092",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EI BCHIP NUMBER",
            "identifier": "412296",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EI BLUE CROSS NUMBER",
            "identifier": "292177",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tsolberg220886@direct.lifespan.org",
            "affiliation": "N",
            "address_1": "727 East Ave",
            "city": "Pawtucket",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028606185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.