Individual provider Active NPI

Jason Rubino, BCBA, LABA (MA)

  • Behavior Analyst
  • Salem, NH
National Provider Identifier
1104274158
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-11-8336
Practice address
254 N Broadway Unit 112
Salem, NH 03079-2132
Phone
(561) 917-7205
NPI assigned
Jun 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 475 MA
Behavior Analyst 103K00000X 1-11-8336 Primary

Addresses

Primary practice location

254 N Broadway Unit 112
Salem, NH 03079-2132

Mailing address

542 Amherst St Ste B
Nashua, NH 03063-1016
Phone (561) 917-7205

Other practice location 1

155 Main Dunstable Rd Ste 150
Nashua, NH 03060-3640
Phone (561) 917-7205

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

LicenseStateTypeSpecialty
475MAMDSports Medicine (Physical Medicine & Rehabilitation) Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1104274158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 AMHERST ST STE B",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030631016",
            "telephone_number": "561-917-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 N BROADWAY UNIT 112",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030792132",
            "telephone_number": "561-917-7205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Main Dunstable Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Nashua",
            "state": "NH",
            "postal_code": "030603640",
            "country_code": "US",
            "telephone_number": "561-917-7205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUBINO",
        "first_name": "JASON",
        "credential": "BCBA, LABA (MA)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-01",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "475",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-11-8336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.