Individual provider Active NPI

Isis B. Casillas

  • Cognitive & Behavioral Psychologist
  • Miami, FL
National Provider Identifier
1649611716
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
Practice address
9415 SW 72ND St Ste 131
Miami, FL 33173-5492
Phone
(305) 662-6448
NPI assigned
Jul 17, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X Primary

Addresses

Primary practice location

9415 SW 72ND St Ste 131
Miami, FL 33173-5492

Mailing address

8980 W Flagler St
Apt. 108
Miami, FL 33174-3963
Phone (786) 280-8505

Other practice location 1

440 Sawgrass Corporate Pkwy
Suite 106
Sunrise, FL 33325-6244
Phone (954) 745-1112

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
Gomez Behavior Services, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1649611716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8980 W FLAGLER ST",
            "address_2": "APT. 108",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331743963",
            "telephone_number": "786-280-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9415 SW 72ND ST STE 131",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331735492",
            "telephone_number": "305-662-6448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "440 Sawgrass Corporate Pkwy",
            "address_2": "Suite 106",
            "address_purpose": "LOCATION",
            "city": "Sunrise",
            "state": "FL",
            "postal_code": "333256244",
            "country_code": "US",
            "telephone_number": "954-745-1112",
            "fax_number": "954-745-1120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASILLAS",
        "first_name": "ISIS",
        "middle_name": "B.",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.