Active NPI
Derek Vincent Martin, MM, BCBA, LBS
- Behavior Analyst
- Wayne, PA
National Provider Identifier
1881236875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BH004643
- Practice address
- 999 Old Eagle School Rd
Wayne, PA 19087-1707 - Phone
- (844) 444-7496
- NPI assigned
- Oct 11, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | BH004643 | PA | Primary |
Addresses
Primary practice location
999 Old Eagle School Rd
Wayne, PA 19087-1707
Mailing address
4620 N State Road 7 Ste 300
Lauderdale Lakes, FL 33319-5867
Phone (561) 323-6593
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BH004643 | PA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspire Autism Inc. | 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 Acclaim Autism
- Community/Behavioral Health Agency
- Lancaster, PA
- NPI 1093523854
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755475200000",
"number": "1881236875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4620 N STATE ROAD 7 STE 300",
"city": "LAUDERDALE LAKES",
"state": "FL",
"postal_code": "333195867",
"telephone_number": "561-323-6593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "999 OLD EAGLE SCHOOL RD",
"city": "WAYNE",
"state": "PA",
"postal_code": "190871707",
"telephone_number": "844-444-7496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "DEREK",
"middle_name": "VINCENT",
"credential": "MM, BCBA, LBS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-10-11",
"last_updated": "2025-08-18",
"certification_date": "2025-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "PA",
"license": "BH004643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayne, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.