Individual provider Active NPI

Imelda Villalobos Mondragon

  • Behavior Technician
  • Melville, NY
National Provider Identifier
1497624837
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
527599491 Issued in NY
Practice address
225 Broadhollow Rd
Melville, NY 11747-4822
Phone
(631) 385-7780
NPI assigned
Nov 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 527599491 NY Primary

Addresses

Primary practice location

225 Broadhollow Rd
Melville, NY 11747-4822

Mailing address

225 Broadhollow Rd Ste 402
Melville, NY 11747-4899
Phone (631) 385-7780

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
527599491NYMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1762128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1497624837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 BROADHOLLOW RD STE 402",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474899",
            "telephone_number": "631-385-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474822",
            "telephone_number": "631-385-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLALOBOS MONDRAGON",
        "first_name": "IMELDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-03",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NY",
            "license": "527599491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; 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.