Elisha Bacon

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1801 SE Hillmoor Dr Ste B101-103
Port Saint Lucie, FL 34952-7553

Phone

(772) 463-0444

NPI assigned

May 1, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Behavior Basics, Incorporated

  • Specialist
  • Port St Lucie, FL
  • NPI 1497913214
  NPD
• Behavior Basics, Incorporated

  • Behavior Analyst
  • Port St Lucie, FL
  • NPI 1538406616
  NPD

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

{
    "created_epoch": "1746057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1548059082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4803 WELLINGTON WAY SW",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329682338",
            "telephone_number": "772-925-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SE HILLMOOR DR STE B101-103",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349527553",
            "telephone_number": "772-463-0444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1887 SE Port St Lucie Blvd",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349525530",
            "country_code": "US",
            "telephone_number": "772-463-0444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACON",
        "first_name": "ELISHA",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-01",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• B.S.L. Construction., Co
• B&K Medical Supplies LLC
• Allison Babwah
• Back in Action, Saint Lucie Physical Therapy LLC
• Back to You Physical Therapy LLC
• Melanie Hope Baculima, MSW
• Joshua James Bailey
• Elizabeth Marian Baize, OWNER
• Cara Baker
• Juliana Baker, RBT

• Behavior Technician in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.