Individual provider Active NPI

Pattie Elaine Bentley, BCBA

  • Behavior Analyst
  • Port St Lucie, FL
National Provider Identifier
1154853612
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
1645 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5428
Phone
(877) 999-0258
NPI assigned
Apr 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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 Primary

Addresses

Primary practice location

1645 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5428

Mailing address

560 Village Blvd Ste 100
West Palm Beach, FL 33409-1963
Phone (613) 335-5681

Other practice location 1

560 Village Blvd Ste 100
West Palm Beach, FL 33409-1963
Phone (561) 335-5681

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
ABA Cares of Florida LLC Behavior Analyst Past Accepting new patients
Sprout Behavioral Services, Inc. Behavior Analyst Past Accepting new patients
ABA Centers of America LLC Behavior Analyst PastSince Sep 5, 2023 Accepting new patients

Organizations & group practices 3

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": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1154853612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 VILLAGE BLVD STE 100",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334091963",
            "telephone_number": "613-335-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525428",
            "telephone_number": "877-999-0258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "560 Village Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334091963",
            "country_code": "US",
            "telephone_number": "561-335-5681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENTLEY",
        "first_name": "PATTIE",
        "middle_name": "ELAINE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.