Active NPI
Dylan Reardon
- Behavior Technician
- West Springfield, MA
National Provider Identifier
1245063353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 478 Rogers Ave
West Springfield, MA 01089-1942 - Phone
- (413) 204-2991
- NPI assigned
- Aug 23, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 Technician | 106S00000X | MA | Primary |
Addresses
Primary practice location
478 Rogers Ave
West Springfield, MA 01089-1942
Mailing address
478 Rogers Ave
West Springfield, MA 01089-1942
Phone (413) 204-2991
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": "1724371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739750400000",
"number": "1245063353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "478 ROGERS AVE",
"city": "WEST SPRINGFIELD",
"state": "MA",
"postal_code": "010891942",
"telephone_number": "413-204-2991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "478 ROGERS AVE",
"city": "WEST SPRINGFIELD",
"state": "MA",
"postal_code": "010891942",
"telephone_number": "413-204-2991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REARDON",
"first_name": "DYLAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-08-23",
"last_updated": "2025-02-17",
"certification_date": "2025-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.