KRISTEN TIDWELL (MS, RD, LD, CNSC) – Registered Dietitian, NPI 1053884742
Registered Dietitian
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
536 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in TX
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Provider Addresses for KRISTEN TIDWELL (MS, RD, LD, CNSC)
15, Veneto Lane, Missouri City, Fort Bend County, Texas, 77459, United States
MISSOURI CITY, TX 774591166
Phone: (281) 995-1323
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-12-09
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190517000793 | I | Registered Dietitian Or Nutrition Professional | TX | TBD |
| I20251209001390 | I | Registered Dietitian Or Nutrition Professional | DC | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 77459)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TX | |
| Nurse Practitioner | TX | |
| Family Practice | TX | |
| - | TX | |
| Nurse Practitioner | TX | |
| Physician Assistant | TX | |
| Nurse Practitioner | TX | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TX | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TX | |
| Nurse Practitioner | TX |
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