Individual provider Active NPI

Brandon Yamaguchi

  • Registered Dietitian
  • Phoenix, AZ
National Provider Identifier
1376433839
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86301258 Issued in AZ
Practice address
10000 N 31St Ave Ste C105
Phoenix, AZ 85051-9625
Phone
(602) 674-1068
Fax
(480) 247-5461
NPI assigned
Jul 7, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86301258 AZ Primary

Addresses

Primary practice location

10000 N 31St Ave Ste C105
Phoenix, AZ 85051-9625

Mailing address

18001 N 79TH Ave Ste A12
Glendale, AZ 85308-8398
Phone (623) 399-6825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250722001854 AZ Practitioner - Registered Dietitian Or Nutrition Professional 9032625546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Am Nutrition ServicesGroup PAC ID 1254430580, 48 clinicians

Practice addresses (Care Compare)

10000 N 31St Ave
Suite C105
Phoenix, AZ 85051-9625
Phone (623) 399-6825

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86301258AZMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Am Nutrition Services Dietitian, Registered CurrentSince Jul 7, 2025 Accepting new patients

Locations

18001 N 79th Ave
Ste A12
Glendale, AZ 85308
Phone (623) 321-5380

10000 N 31st Ave
Ste C105
Phoenix, AZ 85051
Phone (602) 674-1068

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1751846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1376433839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18001 N 79TH AVE STE A12",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088398",
            "telephone_number": "623-399-6825",
            "fax_number": "623-505-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 N 31ST AVE STE C105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850519625",
            "telephone_number": "602-674-1068",
            "fax_number": "480-247-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMAGUCHI",
        "first_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-07",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "86301258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.