Wyatt Jacob Manieri

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

201 King of Prussia Rd Ste 650
Radnor, PA 19087-5156

Phone

(215) 853-6682

Fax

(855) 568-2494

NPI assigned

Sep 13, 2021

Last updated

Sep 13, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Behavior Frontiers, LLC

  dba Behavior Frontiers

  • Behavior Analyst
  • Gardena, CA
  • NPI 1245539394
  NPD (past)

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1659040517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18726 S WESTERN AVE STE 408",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902483858",
            "telephone_number": "310-856-0800",
            "fax_number": "855-568-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 KING OF PRUSSIA RD STE 650",
            "city": "RADNOR",
            "state": "PA",
            "postal_code": "190875156",
            "telephone_number": "215-853-6682",
            "fax_number": "855-568-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIERI",
        "first_name": "WYATT",
        "middle_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Main Line Health Homecare and Hospice (Main Line Health HomeCare and Hospice - home health)
• Main Line Health Homecare and Hospice (Main Line Health HomeCare & Hospice - home health)
• Main Line Health Homecare and Hospice (Main Line Health HomeCare & Hospice - Hospice)
• Main Line Health Homecare and Hospice (Main Line Health HomeCare & Hospice - home health)
• Main Line Health Laboratories
• Derek Alexander Mann, MS
• Mateena Manning
• Marilyn Grace Marencik, FNP-C
• Diajah Martin
• Kathleen Martinez, LPC

• Behavior Technician in Radnor, PA
• Providers in Radnor, PA by specialty
• Behavior Technician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; 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.