Individual provider Active NPI

Adra Pegues

  • Behavior Analyst
  • Bronx, NY
National Provider Identifier
1225487358
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
862445141 Issued in NY
Practice address
304 East 156TH Street
Suite- 13K
Bronx, NY 10451-4856
Phone
(929) 243-2395
NPI assigned
Jun 9, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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 862445141 NY Primary

Addresses

Primary practice location

304 East 156TH Street
Suite- 13K
Bronx, NY 10451-4856

Mailing address

304 East 156TH Street
Suite- 13K
Bronx, NY 10451-4856
Phone (929) 243-2395

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

LicenseStateTypeSpecialty
862445141NYMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1225487358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 EAST 156TH STREET",
            "address_2": "SUITE- 13K",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104514856",
            "telephone_number": "929-243-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 EAST 156TH STREET",
            "address_2": "SUITE- 13K",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104514856",
            "telephone_number": "929-243-2395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEGUES",
        "first_name": "ADRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "862445141",
            "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 Jun 9, 2016; 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.