Individual provider Active NPI

Shelsiam A Reyes Ortiz

  • Behavior Technician
  • Hialeah, FL
National Provider Identifier
1326875972
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-375972 Issued in FL
Practice address
1142 W 41St St
Hialeah, FL 33012-4167
Phone
(786) 617-0682
NPI assigned
Sep 17, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-24-375972 FL Primary

Addresses

Primary practice location

1142 W 41St St
Hialeah, FL 33012-4167

Mailing address

1142 W 41St St
Hialeah, FL 33012-4167
Phone (786) 617-0682

Other identifiers 1

IdentifierTypeStateIssuer
124120100MedicaidFL

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-24-375972FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1326875972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1142 W 41ST ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124167",
            "telephone_number": "786-617-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1142 W 41ST ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124167",
            "telephone_number": "786-617-0682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES ORTIZ",
        "first_name": "SHELSIAM",
        "middle_name": "A",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-17",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-24-375972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124120100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.

Verify at the official NPI Registry.