Individual provider Active NPI

Jonathan D Roos

  • Behavior Analyst
  • Los Angeles, CA
National Provider Identifier
1154687564
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BCBA # 1-10-6879 Issued in CA
Practice address
8936 S Sepulveda Blvd # 200
Los Angeles, CA 90045-3628
Phone
(310) 287-0382
Fax
(310) 861-5014
NPI assigned
Apr 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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 BCBA # 1-10-6879 CA Primary

Addresses

Primary practice location

8936 S Sepulveda Blvd # 200
Los Angeles, CA 90045-3628

Mailing address

8936 S Sepulveda Blvd # 200
Los Angeles, CA 90045-3628
Phone (310) 287-0382

Other identifiers 1

IdentifierTypeStateIssuer
BCBA # 1-10-6879OtherCABCBA CERTIFICATE

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

Practice roles

OrganizationSpecialtyStatusNew patients
Keany Associates Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1154687564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8936 S SEPULVEDA BLVD # 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453628",
            "telephone_number": "310-287-0382",
            "fax_number": "310-861-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8936 S SEPULVEDA BLVD # 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453628",
            "telephone_number": "310-287-0382",
            "fax_number": "310-861-5014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOS",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "BCBA # 1-10-6879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA CERTIFICATE",
            "identifier": "BCBA # 1-10-6879",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.