Individual provider Active NPI

Adam Cisek, RD, LD

  • Registered Dietitian
  • Las Vegas, NV
National Provider Identifier
1669928040
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
39048-PDT-0 Issued in NV
Practice address
2121 E Flamingo Rd
Suite 110
Las Vegas, NV 89119-5122
Phone
(702) 382-8841
Fax
(702) 369-2370
NPI assigned
Aug 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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 39048-PDT-0 NV Primary

Addresses

Primary practice location

2121 E Flamingo Rd
Suite 110
Las Vegas, NV 89119-5122

Mailing address

2121 E Flamingo Rd
Suite 110
Las Vegas, NV 89119-5122
Phone (702) 382-8841

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161024001907 NV Practitioner - Registered Dietitian Or Nutrition Professional 9537447701 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Anders and Dunaway Nutrition Consultants, Inc. Dietitian, Registered CurrentSince Sep 22, 2016 Accepting new patients
Childrens Lung Specialists CurrentSince Jul 11, 2021 Accepting new patients
Pediatric Nutrition of Southern Nevada Current Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients

Locations

3196 S Maryland Pkwy
Ste 209
Las Vegas, NV 89109
Phone (702) 598-4411

3430 E Flamingo Rd
Ste 234
Las Vegas, NV 89121
Phone (702) 382-8841

4040 S Eastern Ave
Ste 210
Las Vegas, NV 89119
Phone (909) 329-5284

2121 E Flamingo Rd
Ste 110
Las Vegas, NV 89119
Phone (702) 382-8841

Organizations & group practices 8

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": "1472169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1669928040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 E FLAMINGO RD",
            "address_2": "SUITE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195122",
            "telephone_number": "702-382-8841",
            "fax_number": "702-369-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E FLAMINGO RD",
            "address_2": "SUITE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195122",
            "telephone_number": "702-382-8841",
            "fax_number": "702-369-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISEK",
        "first_name": "ADAM",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-26",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NV",
            "license": "39048-PDT-0",
            "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 Aug 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.