Individual provider Active NPI

Nicole Marie Santamore, BCBA

  • Behavior Analyst
  • Palm Bay, FL
National Provider Identifier
1568969798
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-23-63664 Issued in FL
Practice address
3061 Dagget Ave SE
Palm Bay, FL 32909-8113
Phone
(321) 408-6393
Fax
(321) 343-3784
NPI assigned
Apr 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-23-63664 FL Primary

Addresses

Primary practice location

3061 Dagget Ave SE
Palm Bay, FL 32909-8113

Mailing address

3061 Dagget Ave SE
Palm Bay, FL 32909-8113
Phone (321) 408-6393

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

Practice roles

OrganizationSpecialtyStatusNew patients
MK ABA, LLC Behavior Analyst Current Accepting new patients
Santamore Nicole LLC Behavior Analyst CurrentSince May 11, 2025 Accepting new patients
The Sonder Academy Behavior Analyst Past Accepting new patients

Locations

2226 Sarno Rd
Ste 100
Melbourne, FL 32935
Phone (321) 313-4804

Organizations & group practices 3

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": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1568969798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3061 DAGGET AVE SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329098113",
            "telephone_number": "321-408-6393",
            "fax_number": "321-343-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3061 DAGGET AVE SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329098113",
            "telephone_number": "321-408-6393",
            "fax_number": "321-343-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTAMORE",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-13",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-23-63664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; 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.