Individual provider Active NPI

Conan Calleja, BCBA

  • Behavior Analyst
  • Homestead, FL
National Provider Identifier
1861908162
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-19-37843 Issued in FL
Practice address
2990 SE 7TH PL
Homestead, FL 33033-5779
Phone
(561) 320-2844
NPI assigned
Dec 21, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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 1-19-37843 FL Primary

Addresses

Primary practice location

2990 SE 7TH PL
Homestead, FL 33033-5779

Mailing address

2990 SE 7TH PL
Homestead, FL 33033-5779
Phone (561) 320-2844

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
Behavior Skills Training LLC Behavior Analyst CurrentSince Apr 16, 2023 Accepting new patients
Nicolas ABA Therapy LLC Behavior Analyst Current Accepting new patients
Zion Behavioral Services LLC Behavior Analyst Current Accepting new patients
Brenda Rivera, Psy.D., P.a. PastSince May 7, 2023 Accepting new patients

Locations

433 Plaza Real
Ste 275
Boca Raton, FL 33432
Phone (561) 262-0084

Organizations & group practices 4

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": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1861908162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 SE 7TH PL",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330335779",
            "telephone_number": "561-320-2844",
            "fax_number": "305-489-5972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 SE 7TH PL",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330335779",
            "telephone_number": "561-320-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLEJA",
        "first_name": "CONAN",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-21",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-19-37843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.