Individual provider Active NPI

Kristin Dominguez, MS, RD, LDN

  • Renal Nutrition Registered Dietitian
  • Hudson, FL
National Provider Identifier
1568128676
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Renal Nutrition Registered DietitianTaxonomy code 133VN1005X
License
ND6160 Issued in FL
Practice address
14134 Nephron LN
Hudson, FL 34667-8554
Phone
(727) 863-5418
NPI assigned
Nov 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Renal Nutrition Registered Dietitian 133VN1005X ND6160 FL Primary

Addresses

Primary practice location

14134 Nephron LN
Hudson, FL 34667-8554

Mailing address

15072 Caravan Ave
Odessa, FL 33556-4376

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220414001629 FL Practitioner - Registered Dietitian Or Nutrition Professional 6709272917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
National Kidney Partners LLPGroup PAC ID 7012981350, 63 clinicians

Practice addresses (Care Compare)

14134 Nephron LN
Hudson, FL 34667-6504
Phone (727) 863-5418

Merit-based Incentive Payment System (MIPS)

Final score
41.84 of 100Reported as group
Quality
43.55
Promoting interoperability
0
Improvement activities
0
Cost
76.34

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
National Kidney Partners, LLP CurrentSince Apr 1, 2022 Accepting new patients

Locations

14134 Nephron Ln
Ste 14134
Hudson, FL 34667

14134 Nephron Ln
Hudson, FL 34667
Phone (727) 863-5418

2967 Landover Blvd
Spring Hill, FL 34608
Phone (352) 684-5323

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kdominguez77017@direct.acumenmd.com

Organizations & group practices 1

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": "1636675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1568128676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15072 CARAVAN AVE",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335564376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14134 NEPHRON LN",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346678554",
            "telephone_number": "727-863-5418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "KRISTIN",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-12",
        "last_updated": "2023-07-06",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "FL",
            "license": "ND6160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.