Individual provider Active NPI

Mylena Avalos Dominguez, RD

  • Registered Dietitian
  • Tucson, AZ
National Provider Identifier
1861970337
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86046227 Issued in AZ
Practice address
839 W Congress St
Tucson, AZ 85745-2819
Phone
(520) 670-3909
Fax
(520) 309-2560
NPI assigned
Aug 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 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 86046227 AZ Primary

Addresses

Primary practice location

839 W Congress St
Tucson, AZ 85745-2819

Mailing address

839 W Congress St
Tucson, AZ 85745-2819
Phone (520) 670-3909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191205001152 AZ Practitioner - Registered Dietitian Or Nutrition Professional 1355695487 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86046227AZMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
El Rio Santa Cruz Neighborhood Health Center, Inc CurrentSince Feb 14, 2020 Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc CurrentSince Feb 14, 2020 Accepting new patients
St Elizabeths Health Center Inc CurrentSince Oct 2, 2019 Accepting new patients
Catholic Community Services of Southern Arizona, Inc. Current Accepting new patients
El Rio Santa Cruz Neighborhood Health Center Past Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc Past Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc Past Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc Past Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc Past Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc Past Accepting new patients

Locations

225 W Irvington Rd
Tucson, AZ 85714
Phone (520) 670-3857

3655 E Grant Rd
Tucson, AZ 85716
Phone (520) 440-6323

434 E University Blvd
Ste 100
Tucson, AZ 85705
Phone (520) 309-4250

1500 W Commerce Ct
Bldg 1
Tucson, AZ 85746
Phone (520) 309-3006

3950 S Country Club Rd
Ste 130
Tucson, AZ 85714
Phone (520) 874-2778

101 W Irvington Rd
Bldg 3C
Tucson, AZ 85714
Phone (520) 573-0096

6950 E Golf Links Rd
Tucson, AZ 85730
Phone (520) 309-3250

1230 S Cherrybell Stra
Tucson, AZ 85713
Phone (520) 310-7316

4550 S Palo Verde Rd
Bldg 1
Tucson, AZ 85714

7490 S Camino de Oeste
Tucson, AZ 85746
Phone (520) 879-6039

140 W Speedway Blvd
Ste 100
Tucson, AZ 85705
Phone (520) 628-7871

839 W Congress St
Tucson, AZ 85745
Phone (520) 670-3707

320 W Prince Rd
Tucson, AZ 85705
Phone (520) 838-7663

Organizations & group practices 21

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.

View all 21

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Rio Santa Cruz Neighborhood Health Center, Inc. 283 clinicians

Practice addresses (Care Compare)

839 W Congress St
Tucson, AZ 85745-2819
Phone (520) 670-3909

NPI Registry JSON

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1861970337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 W CONGRESS ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452819",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 W CONGRESS ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452819",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "MYLENA",
        "middle_name": "AVALOS",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-06",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "86046227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; 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.