NPIMap

Individual provider Active NPI

Tara Gembarowski, M.S. BCBA

  • Behavior Analyst
  • Melbourne, FL
National Provider Identifier
1235559675
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-14-15941 Issued in FL
Practice address
475 S John Rodes Blvd
Melbourne, FL 32904-1093
Phone
(321) 241-1170
Fax
(321) 241-1171
NPI assigned
Apr 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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 1-14-15941 FL Primary

Addresses

Primary practice location

475 S John Rodes Blvd
Melbourne, FL 32904-1093

Mailing address

475 S John Rodes Blvd
Melbourne, FL 32904-1093
Phone (321) 241-1170

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 Science

Practice roles

OrganizationSpecialtyStatusNew patients
The Sonder Academy Behavior Analyst Past Accepting new patients
Paloma Academy Inc Behavior Analyst Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1235559675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 S JOHN RODES BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329041093",
            "telephone_number": "321-241-1170",
            "fax_number": "321-241-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 S JOHN RODES BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329041093",
            "telephone_number": "321-241-1170",
            "fax_number": "321-241-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEMBAROWSKI",
        "first_name": "TARA",
        "credential": "M.S. BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-24",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-14-15941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.