Individual provider Active NPI

Jonathan Lugo, BCBA

  • Behavior Analyst
  • Tarpon Springs, FL
National Provider Identifier
1528566858
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-19-39022 Issued in FL
Practice address
40347 US Highway 19 N Ste 103
Tarpon Springs, FL 34689-4841
Phone
(202) 308-6888
NPI assigned
Feb 1, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X LBA782 MD
Behavior Analyst 103K00000X 1-19-39022 FL Primary

Addresses

Primary practice location

40347 US Highway 19 N Ste 103
Tarpon Springs, FL 34689-4841

Mailing address

5019 Chancellor St NE
St Petersburg, FL 33703-3305
Phone (202) 308-6888

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
LBA782MDMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1528566858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5019 CHANCELLOR ST NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337033305",
            "telephone_number": "202-308-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40347 US HIGHWAY 19 N STE 103",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346894841",
            "telephone_number": "202-308-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUGO",
        "first_name": "JONATHAN",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-01",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MD",
            "license": "LBA782",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-19-39022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarpon Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.