MARIANA GANDOLFO BUSTAMANTE MS, RDN, CD
NPI 1003667072
Dietitian, Registered in Madison, WI

Q: What is Mariana Gandolfo Bustamante's NPI number?

The NPI number for Mariana Gandolfo Bustamante is 1003667072. It was assigned to this individual provider in the NPPES registry on March 28, 2024.

Q: What is Mariana Gandolfo Bustamante's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Active since March 28, 2024

3209 DRYDEN DR, MADISON, WI 53704(608) 241-9020 Get Directions Write a Review

NPPES record last updated: September 22, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mariana Gandolfo Bustamante Ms, Rdn, Cd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARIANA GANDOLFO BUSTAMANTE MS, RDN, CD (NPI 1003667072) is an individual dietitian, registered in Madison, Wisconsin, licensed in Wisconsin (5427-29) and active in the NPI registry since March 2024. She maintains a secondary practice location in Madison and is a graduate of Other (2023).

NPPES Registry Identity

NPI1003667072

Entity TypeIndividualFemale

Primary Taxonomy133V00000X

Provider Legal NameMARIANA GANDOLFO BUSTAMANTECredential: MS, RDN, CD

Location Address3209 DRYDEN DRMadison, WI 53704-3015

Mailing Address7974 Uw Health CtMiddleton, WI 53562-5531

Phone(608) 241-9020

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateMarch 28, 2024

Last NPPES UpdateSeptember 22, 2025

NPPES CertifiedSeptember 22, 2025

✔ NPI 1003667072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers

Taxonomy Code133V00000X

License✔ Licensed in WI · 5427-29

Definition

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

3209 DRYDEN DR, Madison, WI 53704

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Secondary Practice Location 1

Location 1621 Science DrMadison, WI 53711-1074 · Phone (608) 265-8303

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Group Health Cooperative-SCW.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mariana Gandolfo Bustamante Ms, Rdn, Cd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3476058629

PECOS Enrollment IDI20250926002618

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY ZEITLER MD

Student in an Organized Health Care Education/Training Program