Carlos Miyasato

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-24-78664 Issued in IL

Practice address

550 W Saint Charles Rd
Elmhurst, IL 60126-3038

Phone

(815) 469-1500

NPI assigned

May 14, 2018

Last updated

Jan 2, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Westside Childrens Therapy

  • Physical Therapist
  • Joliet, IL
  • NPI 1972783900
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1922598119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 CARPENTER AVE APT 2N",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W SAINT CHARLES RD",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601263038",
            "telephone_number": "815-469-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIYASATO",
        "first_name": "CARLOS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-14",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-24-78664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Talia Abia Mims
• Mindful Connections Behavioral Health PC
• Tina Mingo, C.N.M.
• Dusko Mirjanic, RSA
• Kathryn Mittel
• MKS Care, Inc. (Right at Home Chicago West Suburbs)
• Modern Luxe Therapy PLLC
• Abrar Mohiuddin, DMD
• Sahar Fatima Mohiuddin
• Lissy G Molayal

• Behavior Analyst in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.

Verify at the official NPI Registry.