Jared McConlogue

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BACB474504 Issued in NY

Practice address

70 Pond LN
Levittown, NY 11756-1149

Phone

(516) 796-8485

NPI assigned

May 3, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dragonfly Applied Behavior Analysis PC

  • Behavior Analyst
  • Farmingdale, NY
  • NPI 1639891922
  NPD (past)
• Compass ABA LLC

  • Behavior Analyst
  • Mahwah, NJ
  • NPI 1962003483
  NPD (past)

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1285217794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 POND LN",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117561149",
            "telephone_number": "516-796-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 POND LN",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117561149",
            "telephone_number": "516-796-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONLOGUE",
        "first_name": "JARED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "BACB474504",
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": "NY",
            "license": "BACB474504",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Mathews, MSED.
• Matthew W. Barkoff
• Gina Marie Matton, LMT
• Matturro Dental PC
• Gregory Thomas Maurer, PA-C
• Michael McCristall, ATC, NSCA-CPT
• Lois Ann McEwan
• Stacy Ann McGeechan, MD
• Michael McGuirk, SLP
• Katie McKasty

• Behavior Analyst in Levittown, NY
• Providers in Levittown, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; 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.