Individual provider Active NPI

Samuel Belyea, LMT

  • Behavior Technician
  • Tampa, FL
National Provider Identifier
1598090953
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-364433 Issued in FL
Practice address
3406 W San Pedro St
Tampa, FL 33629
Phone
(904) 710-1547
Fax
(813) 512-2734
NPI assigned
Oct 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA#56213 FL
Behavior Technician 106S00000X RBT-24-364433 FL Primary

Addresses

Primary practice location

3406 W San Pedro St
Tampa, FL 33629

Mailing address

3406 W San Pedro St
Tampa, FL 33629
Phone (904) 710-1547

Other identifiers 1

IdentifierTypeStateIssuer
123325900MedicaidFL

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
RBT-24-364433FLMDBehavior Technician
MA#56213FLMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Above and Beyond Behavior Analysis LLC CurrentSince Nov 10, 2024 Accepting new patients
Above and Beyond Behavior Analysis Virginia CurrentSince Nov 10, 2024 Accepting new patients

Organizations & group practices 2

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": "1254441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1598090953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 W SAN PEDRO ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33629",
            "telephone_number": "904-710-1547",
            "fax_number": "813-200-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3406 W SAN PEDRO ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33629",
            "telephone_number": "904-710-1547",
            "fax_number": "813-512-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELYEA",
        "first_name": "SAMUEL",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-02",
        "last_updated": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA#56213",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-24-364433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123325900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

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