Mariana Gandolfo Bustamante, MS, RDN, CD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

5427-29 Issued in WI

Practice address

3209 Dryden Dr
Madison, WI 53704-3015

Phone

(608) 241-9020

NPI assigned

Mar 28, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• University of Wisconsin Medical Foundation, Inc

  • Multi-Specialty Clinic/Center
  • Middleton, WI
  • NPI 1598784555

  WI

  Medicare reassignment NPD
• University of Wisconsin Medical Foundation, Inc

  • Health Educator
  • Madison, WI
  • NPI 1487414082
  NPD

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1003667072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 DRYDEN DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537043015",
            "telephone_number": "608-241-9020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "621 Science Dr",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537111074",
            "country_code": "US",
            "telephone_number": "608-265-8303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANDOLFO BUSTAMANTE",
        "first_name": "MARIANA",
        "credential": "MS, RDN, CD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-28",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "5427-29",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caleb Paul Ganansky, MD
• Cheryl Ann Ganci, MA, LMFT
• Brian Harrison Gander, M.D.
• Jorja Gander, PHARMD
• Rebecca Janelle Gander, DMD
• Melissa A. Gannage, M.D.
• Kathryn E Gannon-Loew
• Samantha Gannon, OTR
• Laura A Ganske, PT, DPT
• Yingyu Gao, MD

• All providers in Madison, WI
• Registered Dietitian in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.