Individual provider Active NPI

Jessica Louisa Mauro I

  • Behavior Analyst
  • Bellmore, NY
National Provider Identifier
1376315119
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
103K00000X Issued in NY
Practice address
2619 Belmill Rd
Bellmore, NY 11710-4512
Phone
(516) 244-9169
NPI assigned
Oct 25, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 103K00000X NY Primary

Addresses

Primary practice location

2619 Belmill Rd
Bellmore, NY 11710-4512

Mailing address

2619 Belmill Rd
Bellmore, NY 11710-4512
Phone (516) 244-9169

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
103K00000XNYMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1698192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1376315119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2619 BELMILL RD",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117104512",
            "telephone_number": "516-244-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2619 BELMILL RD",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117104512",
            "telephone_number": "516-244-9169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURO",
        "first_name": "JESSICA",
        "middle_name": "LOUISA",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-25",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "103K00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.