Active NPI
Michael Anthony Repoza Jr.
- Behavior Technician
- Riverside, RI
National Provider Identifier
1114865193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 40178433
- Practice address
- 250 Providence Ave
Riverside, RI 02915-3673 - Phone
- (401) 612-8516
- NPI assigned
- Mar 23, 2026
- 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 Technician | 106S00000X | 40178433 | RI | Primary |
Addresses
Primary practice location
250 Providence Ave
Riverside, RI 02915-3673
Mailing address
250 Providence Ave
Riverside, RI 02915-3673
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 |
|---|---|---|---|
| 40178433 | RI | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1774224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774224000000",
"number": "1114865193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 PROVIDENCE AVE",
"city": "RIVERSIDE",
"state": "RI",
"postal_code": "029153673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 PROVIDENCE AVE",
"city": "RIVERSIDE",
"state": "RI",
"postal_code": "029153673",
"telephone_number": "401-612-8516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REPOZA",
"first_name": "MICHAEL",
"middle_name": "ANTHONY",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-03-23",
"last_updated": "2026-03-23",
"certification_date": "2026-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "RI",
"license": "40178433",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.