Active NPI
Donna Gendjar
- Behavior Technician
- Melbourne, FL
National Provider Identifier
1881427300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-366747
- Practice address
- 2210 Sarno Rd
Melbourne, FL 32935-3083 - Phone
- (321) 960-3986
- NPI assigned
- Aug 21, 2024
- Sex
- Female
- 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 Technician | 106S00000X | RBT-24-366747 | FL | Primary |
Addresses
Primary practice location
2210 Sarno Rd
Melbourne, FL 32935-3083
Mailing address
271 McClain Dr
West Melbourne, FL 32904-5105
Phone (321) 960-3986
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 |
|---|---|---|---|
| RBT-24-366747 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MK ABA, LLC | Current | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724198400000",
"number": "1881427300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "271 MCCLAIN DR",
"city": "WEST MELBOURNE",
"state": "FL",
"postal_code": "329045105",
"telephone_number": "321-960-3986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2210 SARNO RD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329353083",
"telephone_number": "321-960-3986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENDJAR",
"first_name": "DONNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-21",
"last_updated": "2024-08-21",
"certification_date": "2024-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-24-366747",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.