Active NPI
Masonor Putu
- Behavior Technician
- Worcester, MA
National Provider Identifier
1902409733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 9 Jefferson St Apt 2F
Worcester, MA 01604-4355 - Phone
- (413) 378-5541
- NPI assigned
- Nov 16, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | S49616671 | MA | |
| Behavior Technician | 106S00000X | MA | Primary |
Addresses
Primary practice location
9 Jefferson St Apt 2F
Worcester, MA 01604-4355
Mailing address
9 Jefferson St Apt 2F
Worcester, MA 01604-4355
Phone (413) 378-5541
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 |
|---|---|---|---|
| S49616671 | MA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605484800000",
"number": "1902409733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 JEFFERSON ST APT 2F",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016044355",
"telephone_number": "413-378-5541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 JEFFERSON ST APT 2F",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016044355",
"telephone_number": "413-378-5541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUTU",
"first_name": "MASONOR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-16",
"last_updated": "2020-11-16",
"certification_date": "2020-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MA",
"license": "S49616671",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.