Individual provider Active NPI

Eric Shafarman

  • Behavior Analyst
  • Woodbury, CT
National Provider Identifier
1396268314
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
58 Pomperaug Rd
Woodbury, CT 06798-3713
Phone
(203) 313-5537
NPI assigned
Jul 21, 2017
Last updated
May 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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 Primary

Addresses

Primary practice location

58 Pomperaug Rd
Woodbury, CT 06798-3713

Mailing address

55 Pepperidge Cir
Stratford, CT 06614-1000
Phone (510) 681-1149

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

Practice roles

OrganizationSpecialtyStatusNew patients
A Brand New Day ABA Services LLC Behavior Analyst CurrentSince May 24, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1500595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1396268314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 PEPPERIDGE CIR",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141000",
            "telephone_number": "510-681-1149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 POMPERAUG RD",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067983713",
            "telephone_number": "203-313-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFARMAN",
        "first_name": "ERIC",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-21",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; 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.