Active NPI
Steven Jr Rodriguez
- Behavior Analyst
- Marlborough, MA
National Provider Identifier
1417340712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1391
- Practice address
- 225 Cedar Hill St Ste 200
Marlborough, MA 01752-5900 - Phone
- (877) 418-2978
- Fax
- (866) 500-2186
- NPI assigned
- Mar 11, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Behavior Analyst | 103K00000X | 1391 | MA | Primary |
Addresses
Primary practice location
225 Cedar Hill St Ste 200
Marlborough, MA 01752-5900
Mailing address
77 Jardine St
Springfield, MA 01107-1750
Phone (413) 374-3307
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110027780B | Medicaid | MA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1391 | MA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Behavioral Associates | Past | 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 and National Provider Directory roles.
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- NPI 1659382315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679097600000",
"number": "1417340712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 JARDINE ST",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011071750",
"telephone_number": "413-374-3307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 CEDAR HILL ST STE 200",
"city": "MARLBOROUGH",
"state": "MA",
"postal_code": "017525900",
"telephone_number": "877-418-2978",
"fax_number": "866-500-2186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "STEVEN",
"middle_name": "JR",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-11",
"last_updated": "2023-03-18",
"certification_date": "2023-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MA",
"license": "1391",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110027780B",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marlborough, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.