Individual provider Active NPI

Jillian Moses, M.A., BCBA, LBA

  • Behavior Analyst
  • Bronx, NY
National Provider Identifier
1215388079
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
11520040 Issued in NY
Practice address
3681 Bruckner Blvd
Bronx, NY 10461-4673
Phone
(646) 345-6954
NPI assigned
Jun 23, 2016
Last updated
Mar 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 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 11520040 NY Primary

Addresses

Primary practice location

3681 Bruckner Blvd
Bronx, NY 10461-4673

Mailing address

1864 7TH Ave
New York, NY 10026-2824

Other practice location 1

1864 7th Ave Apt 44
New York, NY 10026-2842
Phone (646) 345-6954

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
11520040NYMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Inspired Community Project Inc Behavior Analyst CurrentSince Feb 1, 2022 Accepting new patients

Locations

3681 Bruckner Blvd
Bronx, NY 10461
Phone (212) 904-0773

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1215388079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1864 7TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100262824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3681 BRUCKNER BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104614673",
            "telephone_number": "646-345-6954"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1864 7th Ave Apt 44",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100262842",
            "country_code": "US",
            "telephone_number": "646-345-6954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSES",
        "first_name": "JILLIAN",
        "credential": "M.A., BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "11520040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.