Active NPI
Matthew N Avasakdi, BCBA
- Behavior Analyst
- Colorado Springs, CO
National Provider Identifier
1174085393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-20-43166
- Practice address
- 1930 Frequent Flyer PT
Colorado Springs, CO 80915-1500 - Phone
- (941) 275-4422
- NPI assigned
- Apr 5, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-18-50060 | FL | |
| Behavior Analyst | 103K00000X | 1-20-43166 | Primary |
Addresses
Primary practice location
1930 Frequent Flyer PT
Colorado Springs, CO 80915-1500
Mailing address
4140 Brown Stone VW
Colorado Springs, CO 80923-4492
Phone (941) 275-4422
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102463800 | Medicaid | FL |
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 |
|---|---|---|---|
| RBT-18-50060 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615766400000",
"number": "1174085393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4140 BROWN STONE VW",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809234492",
"telephone_number": "941-275-4422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1930 FREQUENT FLYER PT",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809151500",
"telephone_number": "941-275-4422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVASAKDI",
"first_name": "MATTHEW",
"middle_name": "N",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-05",
"last_updated": "2021-03-15",
"certification_date": "2021-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-18-50060",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-20-43166",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102463800",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.