Individual provider Active NPI

Jeffrey Diksa, BCBA

  • Behavior Analyst
  • Wilmington, DE
National Provider Identifier
1164823845
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-14-15909 Issued in DE
Practice address
500 Delaware Ave Ste 102
Wilmington, DE 19801-1490
Phone
(610) 836-2627
NPI assigned
Sep 12, 2014
Last updated
May 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2025

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 1-14-15909 DE Primary

Addresses

Primary practice location

500 Delaware Ave Ste 102
Wilmington, DE 19801-1490

Mailing address

542 Amherst St Ste B
Nashua, NH 03063-1016
Phone (610) 836-2627

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

NPI Registry JSON

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

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1164823845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 AMHERST ST STE B",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030631016",
            "telephone_number": "610-836-2627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DELAWARE AVE STE 102",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198011490",
            "telephone_number": "610-836-2627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIKSA",
        "first_name": "JEFFREY",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-12",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "DE",
            "license": "1-14-15909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.