Active NPI
Stephen P Kilgus, MA
- Behavior Analyst
- Randolph, MA
National Provider Identifier
1881903201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 41 Pacella Park Dr
Randolph, MA 02368-1755 - Phone
- (781) 437-1323
- NPI assigned
- Oct 4, 2010
- 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 | Primary |
Addresses
Primary practice location
41 Pacella Park Dr
Randolph, MA 02368-1755
Mailing address
71 Messenger St
#952
Plainville, MA 02762-2230
Phone (781) 437-1323
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 685661 | Other | MA | TUFTS |
| 110026265E | Medicaid | MA |
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
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286150400000",
"number": "1881903201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "71 MESSENGER ST",
"address_2": "#952",
"city": "PLAINVILLE",
"state": "MA",
"postal_code": "027622230",
"telephone_number": "781-437-1323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 PACELLA PARK DR",
"city": "RANDOLPH",
"state": "MA",
"postal_code": "023681755",
"telephone_number": "781-437-1323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILGUS",
"first_name": "STEPHEN",
"middle_name": "P",
"name_prefix": "Mr.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-04",
"last_updated": "2010-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "685661",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110026265E",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Randolph, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.