Mackenzie Lauren Bachiochi
Individual provider Active NPI Physical Therapy Assistant · Las Vegas, NV
NPI 1104754514 · NPPES record last updated May 13, 2026
Key facts
- NPI
- 1104754514
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- A-0766 (NV)
- Practice address
- 1708 S 15TH St
Las Vegas, NV 89104-3112 - Phone
- (702) 419-2071
- NPI assigned
- May 13, 2026
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-0766 | NV | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A-0766 | NV | Yes |
Addresses
Primary practice location
1708 S 15TH St
Las Vegas, NV 89104-3112
Mailing address
1708 S 15TH St
Las Vegas, NV 89104-3112
Other providers in Las Vegas, NV
- Brandon Baccus
- Carissa Mae Bacena
- Norma Bach
- Vu Nguyen Bach
- Valerie Bachinsky
- Abigail Leigh Bachman
- Rosemarie Bachmann
- Alyssia Bachus
- Shana Quinn Bachus
- Marie Baciak
All providers in Las Vegas, NV · Physical Therapy Assistant in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.