Active NPI
Lucas Patrick Capobianco-Hogan I
- Behavior Analyst
- Orange Park, FL
National Provider Identifier
1780318865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 550 Wells Rd
Orange Park, FL 32073-2969 - Phone
- (877) 823-4283
- NPI assigned
- Jul 13, 2022
- Last updated
- Nov 6, 2024
- Sex
- Male
- 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 | NU | Primary | |
| Behavior Technician | 106S00000X | NU |
Addresses
Primary practice location
550 Wells Rd
Orange Park, FL 32073-2969
Mailing address
35 Windsong Acres Rd
St Augustine, FL 32086-5788
Phone (631) 905-5313
Other practice location 1
12276 San Jose Blvd Ste 508
Jacksonville, FL 32223-8618
Phone (904) 886-3228
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 |
|---|---|---|---|
| Bass Partners LLC | Behavior Analyst | Past | Accepting new patients |
| Behavior Analysis Support Services, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Behavior Analyst
- Altamonte Springs, FL
- NPI 1528617651
-
- Behavior Analyst
- Gainesville, FL
- NPI 1760677017
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730851200000",
"number": "1780318865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 WINDSONG ACRES RD",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320865788",
"telephone_number": "631-905-5313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 WELLS RD",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320732969",
"telephone_number": "877-823-4283"
}
],
"practiceLocations": [
{
"address_1": "12276 San Jose Blvd Ste 508",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322238618",
"country_code": "US",
"telephone_number": "904-886-3228",
"fax_number": "904-485-8876",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CAPOBIANCO-HOGAN",
"first_name": "LUCAS",
"middle_name": "PATRICK",
"name_suffix": "I",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-13",
"last_updated": "2024-11-06",
"certification_date": "2024-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.