Active NPI
Melissa Wintz-Dykstra
- Behavior Analyst
- Albuquerque, NM
National Provider Identifier
1184174013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-20-40546
- Practice address
- 2300 Menaul Blvd NE
Albuquerque, NM 87107-1851 - Phone
- (505) 272-3000
- NPI assigned
- Oct 4, 2016
- Last updated
- Aug 16, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-20-40546 | NM | Primary |
Addresses
Primary practice location
2300 Menaul Blvd NE
Albuquerque, NM 87107-1851
Mailing address
7316 Onate CT NE
Albuquerque, NM 87109-6349
Phone (513) 253-6147
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Your Life ABA VA, LLC | Behavior Analyst | Past | Accepting new patients |
| Jumpstart, LLC | Behavior Analyst | Past | Accepting new patients |
| Jumpstart, LLC | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba JumpStart Autism Screening and Evaluations
- Clinical Child & Adolescent Psychologist
- Albuquerque, NM
- NPI 1477386852
-
- Behavior Analyst
- New York, NY
- NPI 1023772001
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629072000000",
"number": "1184174013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7316 ONATE CT NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871096349",
"telephone_number": "513-253-6147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 MENAUL BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871071851",
"telephone_number": "505-272-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINTZ-DYKSTRA",
"first_name": "MELISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-04",
"last_updated": "2021-08-16",
"certification_date": "2021-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NM",
"license": "1-20-40546",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.