Individual provider Active NPI

Amanda Liane Rugama Leiva

  • Behavior Technician
  • Miami, FL
National Provider Identifier
1659889939
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
13195 SW 134TH St Ste 201
Miami, FL 33186-4585
Phone
(305) 766-3097
NPI assigned
Jan 20, 2018
Last updated
Jun 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary
Behavior Technician 106S00000X FL

Addresses

Primary practice location

13195 SW 134TH St Ste 201
Miami, FL 33186-4585

Mailing address

3801 SW 153Rd CT
Miami, FL 33185-4706
Phone (305) 766-3097

Other practice location 1

11025 SW 84th St # G
Miami, FL 33173-3857
Phone (305) 385-2929

Other identifiers 1

IdentifierTypeStateIssuer
023465900MedicaidFL

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
Thrive Behavior Therapy CurrentSince Mar 19, 2023 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1516406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1659889939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 SW 153RD CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331854706",
            "telephone_number": "305-766-3097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13195 SW 134TH ST STE 201",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864585",
            "telephone_number": "305-766-3097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11025 SW 84th St # G",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331733857",
            "country_code": "US",
            "telephone_number": "305-385-2929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUGAMA LEIVA",
        "first_name": "AMANDA",
        "middle_name": "LIANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-20",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023465900",
            "state": "FL"
        }
    ],
    "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 Jun 6, 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.