Active NPI
Keyanne Barbosa, RBT
- Behavior Analyst
- Stuart, FL
National Provider Identifier
1730651522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-21-52074
- Practice address
- 821 SE Ocean Blvd Ste B
Stuart, FL 34994-2456 - Phone
- (772) 872-6940
- NPI assigned
- Dec 18, 2018
- Last updated
- Oct 21, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-21-52074 | FL | Primary |
| Behavior Technician | 106S00000X | FL |
Addresses
Primary practice location
821 SE Ocean Blvd Ste B
Stuart, FL 34994-2456
Mailing address
3344 NE Sandra Dr
Jensen Beach, FL 34957-3972
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 021662100 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | keyanne@cbgaba.com |
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nicole Vendette, LLC | Behavior Analyst | Past | 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.
-
dba The Collaborative Behavior Group
- Community/Behavioral Health Agency
- Port Saint Lucie, FL
- NPI 1093298564
Behavior Analyst
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634774400000",
"number": "1730651522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3344 NE SANDRA DR",
"city": "JENSEN BEACH",
"state": "FL",
"postal_code": "349573972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "821 SE OCEAN BLVD STE B",
"city": "STUART",
"state": "FL",
"postal_code": "349942456",
"telephone_number": "772-872-6940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARBOSA",
"first_name": "KEYANNE",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-18",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "1-21-52074",
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "021662100",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "keyanne@cbgaba.com",
"affiliation": "N",
"address_1": "821 SE Ocean Blvd Ste B",
"city": "Stuart",
"state": "FL",
"country_code": "US",
"postal_code": "349942456",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Stuart, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.