Individual provider Active NPI

Kyle Mazurowski

  • Nurse's Aide
  • Scottsdale, AZ
National Provider Identifier
1104660554
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
274375 Issued in AZ
Practice address
8850 E Pima Center Pkwy
Scottsdale, AZ 85258-4619
Phone
(480) 800-3900
NPI assigned
Jun 20, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 274375 AZ Primary

Addresses

Primary practice location

8850 E Pima Center Pkwy
Scottsdale, AZ 85258-4619

Mailing address

14849 N Kings Way Unit 223
Fountain Hills, AZ 85268-2974
Phone (480) 387-9721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
274375AZMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1718841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1104660554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14849 N KINGS WAY UNIT 223",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852682974",
            "telephone_number": "480-387-9721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8850 E PIMA CENTER PKWY",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584619",
            "telephone_number": "480-800-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZUROWSKI",
        "first_name": "KYLE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "AZ",
            "license": "274375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.