Matt McIntire, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-17-25047 Issued in HI

Practice address

427 Ala Makani St # 201
Kahului, HI 96732-3507

Phone

(808) 244-6879

Fax

(808) 873-0272

NPI assigned

Dec 3, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1528303583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 ALA MAKANI ST # 201",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967323507",
            "telephone_number": "808-244-6879",
            "fax_number": "808-873-0272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 ALA MAKANI ST # 201",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967323507",
            "telephone_number": "808-244-6879",
            "fax_number": "808-873-0272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3731 6th Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921034383",
            "country_code": "US",
            "telephone_number": "619-278-0884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCINTIRE",
        "first_name": "MATT",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "HI",
            "license": "1-17-25047",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "BCABA: 0-10-3947",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Kahului, HI
• Providers in Kahului, HI by specialty
• Behavior Analyst in Hawaii

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