Ai Jia Primavera, BCBA, LABA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

100000531 Issued in MA

Practice address

54 Middlesex Tpke Ste 103
Bedford, MA 01730-1411

Phone

(617) 803-7717

NPI assigned

Apr 25, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ai Jia Tan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1700632254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 MIDDLESEX TPKE STE 103",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301411",
            "telephone_number": "617-803-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 MIDDLESEX TPKE STE 103",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301411",
            "telephone_number": "617-803-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIMAVERA",
        "first_name": "AI JIA",
        "credential": "BCBA, LABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-25",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "100000531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AI JIA",
            "last_name": "TAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Poole, LCSW
• Juan Carlos Portela Medina
• Catherine Carroll Pouche
• Emily Jean Prast, O.D.
• Elizabeth Price
• Karen Marie Prince, LICSW
• Pro Motion Physical Therapy, Inc.
• Nearyrodh Promket, OD
• Stephen D Proper, R.PH
• Pt4U

• Behavior Analyst in Bedford, MA
• Providers in Bedford, MA by specialty
• Behavior Analyst in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.