Molly E Bauer, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

003202-01 Issued in NY

Practice address

280 Crossways Park Dr
Woodbury, NY 11797-2015

Phone

(516) 938-1784

NPI assigned

Nov 27, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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.

• New York Therapy Placement Services Inc.

  • Early Intervention Provider Agency
  • Port Jefferson Station, NY
  • NPI 1558507210
  NPD (past)

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1316713902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 NEWPORT AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631847",
            "telephone_number": "516-780-1493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 CROSSWAYS PARK DR",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972015",
            "telephone_number": "516-938-1784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "299 Hallock Ave",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson Station",
            "state": "NY",
            "postal_code": "117761217",
            "country_code": "US",
            "telephone_number": "631-473-4284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUER",
        "first_name": "MOLLY",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "003202-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Attivissimo, COTA
• Emad Samy Awadallah
• Jeanine Baldassarri, MA CCC-SLP
• Ashley Asalle Baratian
• Tamer Barsom
• Richard Alan Bauman, OPTICIAN
• Bayside Medical PC
• Lauren Beek
• Kelly Michele Behan, M.S., CCC-SLP, TSSLD
• Max Ryan Benezra, EDM, MA, LMHC

• Behavior Analyst in Woodbury, NY
• Providers in Woodbury, 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 Nov 27, 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.