Active NPI
Mato Topa Augustine, B.C.B.A
- Behavior Analyst
- Kentwood, MI
National Provider Identifier
1467898759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-10-7442
- Practice address
- 3361 36TH St SE
Kentwood, MI 49512-2809 - Phone
- (616) 942-2522
- NPI assigned
- May 14, 2013
- Last updated
- May 14, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-10-7442 | MA | Primary |
Addresses
Primary practice location
3361 36TH St SE
Kentwood, MI 49512-2809
Mailing address
3361 36TH St SE
Kentwood, MI 49512-2809
Phone (616) 942-2522
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hope Network Behavioral Health Services | Past | Accepting new patients | |
| Hope Network Behavioral Health Services | Past | Accepting new patients |
Organizations & group practices 2
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368489600000",
"number": "1467898759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3361 36TH ST SE",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495122809",
"telephone_number": "616-942-2522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3361 36TH ST SE",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495122809",
"telephone_number": "616-942-2522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUGUSTINE",
"first_name": "MATO TOPA",
"credential": "B.C.B.A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-14",
"last_updated": "2013-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MA",
"license": "1-10-7442",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kentwood, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.