Jessica Rose Bancewicz

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

135 Gold Star Blvd
Worcester, MA 01606-2738

Phone

(855) 496-8462

NPI assigned

Jan 11, 2022

Reactivated

Mar 3, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1124779145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 BRIGHAM HILL RD",
            "city": "NORTH GRAFTON",
            "state": "MA",
            "postal_code": "015361244",
            "telephone_number": "508-963-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 GOLD STAR BLVD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062738",
            "telephone_number": "855-496-8462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANCEWICZ",
        "first_name": "JESSICA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-11",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "deactivation_date": "2025-02-21",
        "reactivation_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Christopher Ballinger
• Shelby Friel Ballou, DO
• Leora Beth Balsam, M.D.
• Laurel Lynn Banach, MD
• Gisela Irene Banauch, M.D.
• Darcy Banco, MD
• Kyle Bancroft
• Tuysa Bandeira Moreira
• Prisca B Bangandozou, NP
• Eralda Bango

• Behavior Technician in Worcester, MA
• Providers in Worcester, MA by specialty
• Behavior Technician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.