Individual provider Active NPI

Rebecca Jane Polaschek

  • Behavior Analyst
  • San Antonio, TX
National Provider Identifier
1255988945
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-20-43668 Issued in TX
Practice address
122 Roy Smith St
San Antonio, TX 78215-1361
Phone
(910) 580-1011
NPI assigned
Aug 19, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-15-05932 NC
Behavior Analyst 103K00000X 1-20-43668 TX Primary

Addresses

Primary practice location

122 Roy Smith St
San Antonio, TX 78215-1361

Mailing address

122 Roy Smith St
San Antonio, TX 78215-1361
Phone (910) 580-1011

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Rpolasch08@gmail.com Direct

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
RBT-15-05932NCMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1255988945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 ROY SMITH ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782151361",
            "telephone_number": "910-580-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 ROY SMITH ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782151361",
            "telephone_number": "910-580-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLASCHEK",
        "first_name": "REBECCA",
        "middle_name": "JANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-19",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NC",
            "license": "RBT-15-05932",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-20-43668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Rpolasch08@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Personal email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12222 Vance Jackson Rd",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782305936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.