Individual provider Active NPI

Yanelis Concepcion

  • Behavior Technician
  • Miami Gardens, FL
National Provider Identifier
1184104663
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
19564 NW 50TH CT
Miami Gardens, FL 33055-2077
Phone
(786) 768-9464
NPI assigned
Aug 15, 2018
Last updated
Aug 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X FL Primary

Addresses

Primary practice location

19564 NW 50TH CT
Miami Gardens, FL 33055-2077

Mailing address

19564 NW 50TH CT
Miami Gardens, FL 33055-2077
Phone (786) 768-9464

Other identifiers 1

IdentifierTypeStateIssuer
021834400MedicaidFL

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": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1184104663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19564 NW 50TH CT",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330552077",
            "telephone_number": "786-768-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19564 NW 50TH CT",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330552077",
            "telephone_number": "786-768-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONCEPCION",
        "first_name": "YANELIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021834400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.