NPIMap

Individual provider Active NPI

Richard Michael Peksa, BCABA

  • Behavior Analyst
  • Trumbull, CT
National Provider Identifier
1770889677
Registry record updated Feb 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0-10-3800 Issued in CT
Practice address
39 Lindeman Dr
Trumbull, CT 06611-4740
Phone
(203) 332-4535
Fax
(203) 332-4545
NPI assigned
Feb 10, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2011

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 0-10-3800 CT Primary

Addresses

Primary practice location

39 Lindeman Dr
Trumbull, CT 06611-4740

Mailing address

39 Lindeman Dr
Trumbull, CT 06611-4740
Phone (203) 332-4535

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

OrganizationSpecialtyStatusNew patients
The Kennedy Collective, Inc. Past Accepting new patients
The Kennedy Collective, Inc. Behavior Analyst Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1297296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297296000000",
    "number": "1770889677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 LINDEMAN DR",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114740",
            "telephone_number": "203-332-4535",
            "fax_number": "203-332-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 LINDEMAN DR",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114740",
            "telephone_number": "203-332-4535",
            "fax_number": "203-332-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEKSA",
        "first_name": "RICHARD",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "BCABA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-10",
        "last_updated": "2011-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CT",
            "license": "0-10-3800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2011; 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.