Individual provider Active NPI

Ajani Burgess

  • Behavior Analyst
  • Saint Albans, NY
National Provider Identifier
1104730852
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
19140 112TH Rd
Saint Albans, NY 11412-2412
Phone
(347) 388-6913
NPI assigned
Sep 30, 2026
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NY Primary

Addresses

Primary practice location

19140 112TH Rd
Saint Albans, NY 11412-2412

Mailing address

400 W 61St St Apt 1215
New York, NY 10023-0223
Phone (347) 388-6913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1104730852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W 61ST ST APT 1215",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100230223",
            "telephone_number": "347-388-6913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19140 112TH RD",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114122412",
            "telephone_number": "347-388-6913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "AJANI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-30",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Albans, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.