Active NPI
Matthew Ryan Wilson, LBA, BCBA
- Behavior Analyst
- Bellevue, WA
National Provider Identifier
1649667692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BA60928333
- Practice address
- 2310 130TH Ave NE Ste 202
Bellevue, WA 98005-1761 - Phone
- (425) 882-8868
- NPI assigned
- Apr 16, 2015
- Sex
- Male
- Sole proprietor
- No
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 | BA60928333 | WA | Primary |
Addresses
Primary practice location
2310 130TH Ave NE Ste 202
Bellevue, WA 98005-1761
Mailing address
2310 130TH Ave NE Ste 202
Bellevue, WA 98005-1761
Phone (425) 882-8868
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 |
|---|---|---|---|
| BA60928333 | WA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sum of Learning, LLC | 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.
-
- Community/Behavioral Health Agency
- Bellevue, WA
- NPI 1033525084
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549324800000",
"number": "1649667692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2310 130TH AVE NE STE 202",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980051761",
"telephone_number": "425-882-8868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2310 130TH AVE NE STE 202",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980051761",
"telephone_number": "425-882-8868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MATTHEW",
"middle_name": "RYAN",
"credential": "LBA, BCBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-16",
"last_updated": "2019-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "WA",
"license": "BA60928333",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.