Individual provider Active NPI

Matthew Joseph Fogarty

  • Behavior Analyst
  • Woodside, NY
National Provider Identifier
1710886452
Registry record updated Oct 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
005353 Issued in NY
Practice address
3121 54TH St
Woodside, NY 11377-1531
Phone
(516) 404-6800
NPI assigned
Oct 31, 2026
Last updated
Oct 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 005353 NY Primary

Addresses

Primary practice location

3121 54TH St
Woodside, NY 11377-1531

Mailing address

3121 54TH St
Woodside, NY 11377-1531
Phone (516) 404-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1793404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793404800000",
    "number": "1710886452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 54TH ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113771531",
            "telephone_number": "516-404-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 54TH ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113771531",
            "telephone_number": "516-404-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGARTY",
        "first_name": "MATTHEW",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-31",
        "last_updated": "2026-10-31",
        "certification_date": "2026-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "005353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.