Active NPI
Mary E Andruszkiewicz, RD, CD
- Registered Dietitian
- Waukesha, WI
National Provider Identifier
1114088069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 784-029
- Practice address
- 615 W Moreland Blvd
Waukesha, WI 53188-2462 - Phone
- (262) 896-8430
- Fax
- (262) 970-6670
- NPI assigned
- Dec 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 784-029 | WI | Primary |
Addresses
Primary practice location
615 W Moreland Blvd
Waukesha, WI 53188-2462
Mailing address
615 W Moreland Blvd
Waukesha, WI 53188-2462
Phone (262) 896-8430
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
| License | State | Type | Specialty |
|---|---|---|---|
| 784-029 | WI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114088069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 W MORELAND BLVD",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531882462",
"telephone_number": "262-896-8430",
"fax_number": "262-970-6670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 W MORELAND BLVD",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531882462",
"telephone_number": "262-896-8430",
"fax_number": "262-970-6670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRUSZKIEWICZ",
"first_name": "MARY",
"middle_name": "E",
"name_prefix": "Ms.",
"credential": "RD, CD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "784-029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.