Individual provider Active NPI

Iris Mae Pevzner, RBT

  • Behavior Technician
  • Plymouth, MA
National Provider Identifier
1104712447
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-394096 Issued in MA
Practice address
160 Bartlett Rd
Plymouth, MA 02360-1578
Phone
(781) 424-9877
NPI assigned
Jun 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-24-394096 MA Primary

Addresses

Primary practice location

160 Bartlett Rd
Plymouth, MA 02360-1578

Mailing address

160 Bartlett Rd
Plymouth, MA 02360-1578
Phone (781) 424-9877

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
RBT-24-394096MAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1749772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1104712447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 BARTLETT RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023601578",
            "telephone_number": "781-424-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 BARTLETT RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023601578",
            "telephone_number": "781-424-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEVZNER",
        "first_name": "IRIS",
        "middle_name": "MAE",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-13",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MA",
            "license": "RBT-24-394096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.