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Deactivated NPI 1609367465 Deactivated / Inactive NPI Male Practitioner

Michael J Defazio

Driver • Las Vegas, NV

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Michael Defazio has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 28, 2018
NPI Deactivation Date February 05, 2026
Total Practice Duration ~8 Years of Practice (2018 – 2026)

Professional Overview & Biography Verified Profile Summary

Michael Defazio was a registered Driver practicing in Las Vegas, NV. Throughout an active medical career spanning 8 years, Michael Defazio provided care at the practice location at 6755 SHELTER LN until profile deactivation on 2026-02-05.

Practice Location & Contact Primary Location

Practice Address

6755 Shelter Ln

Las Vegas, NV 891034369

Telephone 7025212350

Specialty Benchmarks & Practice Insights

Comparative analytics for Driver in Las Vegas, NV

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
28 Specialists

Practicing in Las Vegas, NV (39 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Driver Primary Specialty

NUCC Taxonomy Code: 172A00000X

State License CA A1953895

A person employed to operate a motor vehicle as a carrier of persons or property.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated February 05, 2026

Record deactivated on February 05, 2026

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NPI Profile Active May 28, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location May 28, 2018

Registered at 6755 SHELTER LN, LAS VEGAS, NV 891034369 (Tel: 7025212350)

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Updated Business Mailing Address May 28, 2018

Registered at 6755 SHELTER LN, LAS VEGAS, NV 891034369 (Tel: 7025212350)

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Provider Name / Credentials Updated May 28, 2018

Recorded as MICHAEL DEFAZIO

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 28, 2018

Driver (License #A1953895 in CA)

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Initial NPI Registration & Enumeration May 28, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1609367465
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 28, 2018
Last Update: May 28, 2018
Deactivation Date: February 05, 2026
Update or Correct Profile

Mailing Address

6755 Shelter Ln

Las Vegas, NV 891034369

Phone: 7025212350

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.