Active NPI
Matthew Rengifo
- Behavior Analyst
- Palmetto Bay, FL
National Provider Identifier
1548885288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- RBT20121455
- Practice address
- 15800 SW 92ND Ave
Palmetto Bay, FL 33157-1843 - Phone
- (786) 602-2981
- NPI assigned
- Jun 9, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | RBT20121455 | FL | Primary |
Addresses
Primary practice location
15800 SW 92ND Ave
Palmetto Bay, FL 33157-1843
Mailing address
15800 SW 92ND Ave
Palmetto Bay, FL 33157-1843
Phone (786) 602-2981
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | MIAMI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT20121455 | FL | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591660800000",
"number": "1548885288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15800 SW 92ND AVE",
"city": "PALMETTO BAY",
"state": "FL",
"postal_code": "331571843",
"telephone_number": "786-602-2981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15800 SW 92ND AVE",
"city": "PALMETTO BAY",
"state": "FL",
"postal_code": "331571843",
"telephone_number": "786-602-2981"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENGIFO",
"first_name": "MATTHEW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-09",
"last_updated": "2020-06-09",
"certification_date": "2020-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "RBT20121455",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "MIAMI",
"affiliation": "N",
"address_1": "15800 SW 92nd Ave",
"city": "Palmetto Bay",
"state": "FL",
"country_code": "US",
"postal_code": "331571843",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Palmetto Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.