Active NPI
Matthew McBrady
- Behavior Analyst
- Orlando, FL
National Provider Identifier
1003481920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1867
- Practice address
- 2154 Central Florida Pkwy Ste B2
Orlando, FL 32837-8986 - Phone
- (407) 674-7670
- NPI assigned
- May 24, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1867 | NC | Primary |
| Behavior Technician | 106S00000X |
Addresses
Primary practice location
2154 Central Florida Pkwy Ste B2
Orlando, FL 32837-8986
Mailing address
3355 S Kirkman Rd
Orlando, FL 32811-1947
Other practice location 1
390 S Liberty St
Winston Salem, NC 27101-5260
Phone (336) 934-4058
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1867 | NC | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Azalea Behavioral Services LLC | Behavior Analyst | Current | Accepting new patients |
| Complete Rehabilitation and Sports Physical Therapy, PC | Past | Accepting new patients | |
| Amazing Gains Behavior Therapy Services LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Behavior Analyst
- Carolina Beach, NC
- NPI 1588536767
-
- Early Intervention Provider Agency
- Orlando, FL
- NPI 1518488212
-
- Physical Therapist
- Ronkonkoma, NY
- NPI 1811097306
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729555200000",
"number": "1003481920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3355 S KIRKMAN RD",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328111947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2154 CENTRAL FLORIDA PKWY STE B2",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328378986",
"telephone_number": "407-674-7670"
}
],
"practiceLocations": [
{
"address_1": "390 S Liberty St",
"address_purpose": "LOCATION",
"city": "Winston Salem",
"state": "NC",
"postal_code": "271015260",
"country_code": "US",
"telephone_number": "336-934-4058",
"fax_number": "743-255-3010",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCBRADY",
"first_name": "MATTHEW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-05-24",
"last_updated": "2024-10-22",
"certification_date": "2024-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NC",
"license": "1867",
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.