Matthew R Dejesus

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-24-76981 Issued in IN

Practice address

6131 N Clinton St
Fort Wayne, IN 46825-4905

Phone

(260) 459-6040

NPI assigned

Jan 31, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Children'S Autism Center, Inc

  • Developmental Disabilities Clinic/Center
  • Fort Wayne, IN
  • NPI 1215105663
  NPD (past)

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

{
    "created_epoch": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1689205387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E RUDISILL BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468061738",
            "telephone_number": "260-255-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6131 N CLINTON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468254905",
            "telephone_number": "260-459-6040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4422 E State Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468156917",
            "country_code": "US",
            "telephone_number": "260-471-9263",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEJESUS",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-31",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IN",
            "license": "RBT-19-106957",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-24-76981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Marie Dehaven, PHARMD
• Abby Dehoff
• Benjamin Dehr
• Jenna Deininger, PHARMD, RPH
• Julie Suzanne Dejesus, LMHCA
• Pamela S Dekoninck, MS, RN, AGPCNP-BC
• Aleea Del Cid
• Susan Delagrange, RDCD
• Rachel Delamarter
• Charlene Delaney, MT-BC

• Behavior Analyst in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Behavior Analyst in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.