Active NPI
Benjamin Wantman, BCBA, MSED
- Behavior Analyst
- Bellevue, WA
National Provider Identifier
1023620671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-20-43340
- Practice address
- 929 109TH Ave NE
Bellevue, WA 98004-4404 - Phone
- (425) 326-1545
- NPI assigned
- Aug 17, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-20-43340 | Primary |
Addresses
Primary practice location
929 109TH Ave NE
Bellevue, WA 98004-4404
Mailing address
3010 118TH Ave SE
Bellevue, WA 98005-4137
Phone (203) 417-8314
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597622400000",
"number": "1023620671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3010 118TH AVE SE",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980054137",
"telephone_number": "203-417-8314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "929 109TH AVE NE",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980044404",
"telephone_number": "425-326-1545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANTMAN",
"first_name": "BENJAMIN",
"credential": "BCBA, MSED",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-17",
"last_updated": "2020-08-17",
"certification_date": "2020-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-20-43340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.