Individual provider Active NPI

Samara Cotumaccio

  • Behavior Analyst
  • New York, NY
National Provider Identifier
1629701008
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
60 Madison Ave FL 10
New York, NY 10010-1600
Phone
(212) 481-1664
NPI assigned
Jul 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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 BACB468619 NY
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

60 Madison Ave FL 10
New York, NY 10010-1600

Mailing address

21600 Oxnard St Ste 1800
Woodland Hills, CA 91367-7807
Phone (914) 629-2053

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
BACB468619NYMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1629701008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21600 OXNARD ST STE 1800",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913677807",
            "telephone_number": "914-629-2053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MADISON AVE FL 10",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100101600",
            "telephone_number": "212-481-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTUMACCIO",
        "first_name": "SAMARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "BACB468619",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.