Individual provider Active NPI

Alyssa Bates

  • Behavior Analyst
  • St Augustine, FL
National Provider Identifier
1497294565
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-19-34807
Practice address
1750 Tree Blvd Ste 6
St Augustine, FL 32084-5719
Phone
(904) 206-7024
NPI assigned
Feb 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-16-25232 PA
Behavior Analyst 103K00000X 1-19-34807 Primary

Addresses

Primary practice location

1750 Tree Blvd Ste 6
St Augustine, FL 32084-5719

Mailing address

936 Scheidel Way
St Augustine, FL 32084-6617
Phone (412) 652-3022

Other practice location 1

936 Scheidel Way
St Augustine, FL 32084-6617
Phone (412) 652-3022

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-16-25232PAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Allay Behavioral Therapy, LLC Behavior Analyst CurrentSince Feb 8, 2023 Accepting new patients

Locations

3100 US Highway 1 S
Ste 5
Saint Augustine, FL 32086
Phone (904) 206-7024

1750 Tree Blvd
Ste 6
St Augustine, FL 32084
Phone (904) 206-7024

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.

NPI Registry JSON

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1497294565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 SCHEIDEL WAY",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320846617",
            "telephone_number": "412-652-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 TREE BLVD STE 6",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320845719",
            "telephone_number": "904-206-7024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "936 Scheidel Way",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320846617",
            "country_code": "US",
            "telephone_number": "412-652-3022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BATES",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-21",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "PA",
            "license": "RBT-16-25232",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-19-34807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.