Individual provider Active NPI

Cynthia E. Martinez, M.S. ED, BCBA, LBA

  • Behavior Analyst
  • New Hyde Park, NY
National Provider Identifier
1528490216
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
002277 Issued in NY
Practice address
2417 Jericho Tpke
New Hyde Park, NY 11040-4710
Phone
(516) 778-8871
NPI assigned
Aug 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 730174131 NY
Behavior Analyst 103K00000X 002277 NY Primary

Addresses

Primary practice location

2417 Jericho Tpke
New Hyde Park, NY 11040-4710

Mailing address

2698 Riverside Ave
Merrick, NY 11566-4515
Phone (917) 496-6144

Other practice location 1

3810 Broadway
Apt 2-i
New York, NY 10032-1502
Phone (917) 496-6144

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
730174131NYMDSpecialist
002277NYMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Applied Behavior Analysis PLLC Behavior Analyst CurrentSince Dec 17, 2023 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.

NPI Registry JSON

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

{
    "created_epoch": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1528490216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2698 RIVERSIDE AVE",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664515",
            "telephone_number": "917-496-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2417 JERICHO TPKE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110404710",
            "telephone_number": "516-778-8871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3810 Broadway",
            "address_2": "Apt 2-i",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100321502",
            "country_code": "US",
            "telephone_number": "917-496-6144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "CYNTHIA",
        "middle_name": "E.",
        "credential": "M.S. ED, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-05",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "730174131",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "002277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.