Individual provider Active NPI

Michelle Mazurowski, MS,RDN,LD,LPTA

  • Registered Dietitian
  • Las Vegas, NV
National Provider Identifier
1639511652
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
929429 Issued in NV
Practice address
3425 Cliff Shadows Pkwy Ste 130
Las Vegas, NV 89129-5113
Phone
(702) 664-1204
Fax
(702) 537-7114
NPI assigned
Jul 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

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 929429 NV Primary

Addresses

Primary practice location

3425 Cliff Shadows Pkwy Ste 130
Las Vegas, NV 89129-5113

Mailing address

11829 Luna del Mar LN
Las Vegas, NV 89138-4529
Phone (702) 664-1204

Other practice location 1

4215 S Grand Canyon Dr Ste 101
Las Vegas, NV 89147-7173
Phone (702) 580-9742

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141010000274 NV Practitioner - Registered Dietitian Or Nutrition Professional 9032339346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4215 S Grand Canyon Dr
Suite 101
Las Vegas, NV 89147-7173
Phone (702) 664-1204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
929429NVMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Food Connection LLC Dietitian, Registered CurrentSince Jul 29, 2014 Accepting new patients
Integrated Health and Wellness Center LLC PastSince Mar 1, 2017 Accepting new patients

Locations

4215 S Grand Canyon Dr
Ste 101
Las Vegas, NV 89147
Phone (702) 448-6042

3425 Cliff Shadows Pkwy
Ste 130
Las Vegas, NV 89129
Phone (702) 448-6042

Organizations & group practices 2

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": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1639511652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11829 LUNA DEL MAR LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891384529",
            "telephone_number": "702-664-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 CLIFF SHADOWS PKWY STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891295113",
            "telephone_number": "702-664-1204",
            "fax_number": "702-537-7114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4215 S Grand Canyon Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891477173",
            "country_code": "US",
            "telephone_number": "702-580-9742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZUROWSKI",
        "first_name": "MICHELLE",
        "credential": "MS,RDN,LD,LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-18",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NV",
            "license": "929429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2026; 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.