Individual provider Active NPI

Andrew Vivadelli

  • Behavior Technician
  • Boynton Beach, FL
National Provider Identifier
1740838192
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
4895 Windward Passage Dr Ste 6
Boynton Beach, FL 33436-7741
Phone
(561) 877-8753
Fax
(561) 877-8759
NPI assigned
Aug 29, 2019
Last updated
Aug 29, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

4895 Windward Passage Dr Ste 6
Boynton Beach, FL 33436-7741

Mailing address

4895 Windward Passage Dr Ste 6
Boynton Beach, FL 33436-7741
Phone (561) 877-8753

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

NPI Registry JSON

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1740838192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4895 WINDWARD PASSAGE DR STE 6",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334367741",
            "telephone_number": "561-877-8753",
            "fax_number": "561-877-8759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4895 WINDWARD PASSAGE DR STE 6",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334367741",
            "telephone_number": "561-877-8753",
            "fax_number": "561-877-8759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVADELLI",
        "first_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-29",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; 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.