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Samuel Barrett

Behavior Technician β€’ Fort Wayne, IN

Active NPI 1568962777 Individual Practitioner Male Practitioner
Practice location in NPPES

12912 Coldwater Rd Ste E
Fort Wayne, IN 468458871

Call 2602451455 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

12912 Coldwater Rd Ste E

Fort Wayne, IN 468458871

Telephone 2602451455
Fax 3178153861
Organization at the Same NPPES Address or Phone
Fort Wayne Autism Center Inc Facility NPI 1750664561

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 2 distinct additional practice-address records in Fort Wayne, IN. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2018

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Fort Wayne and Indiana

1,191 active clinicians are listed under Behavior Technician with a practice address in Fort Wayne, IN (17,054 in Indiana).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Fort Wayne

0% of these 1,191 clinicians have the CMS telehealth indicator.

0% of these 1,191 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Behavior Technician Primary Specialty

NUCC Taxonomy Code: 106S00000X

The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Indiana Professional Licensing Agency.
Look Up on State Board Site

Secondary Practice Locations

5750 Falls Dr Ste 102

Fort Wayne, IN 468047147

Phone: 2602451455

3948 New Vision Dr Ste D

Fort Wayne, IN 468451721

Phone: 2602451455

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

11 Historical Events
βœ…
NPI Profile Active March 17, 2018

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location March 17, 2018

Registered at 12912 COLDWATER RD STE E, FORT WAYNE, IN 468458871 (Tel: 2602451455)

πŸ“
Updated Business Mailing Address March 17, 2018

Registered at 6060 N COLLEGE AVE, INDIANAPOLIS, IN 462201907 (Tel: 3175845166)

πŸ‘€
Provider Name / Credentials Updated March 17, 2018

Recorded as SAMUEL BARRETT

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2018

Behavior Technician

βœ…
NPI Profile Active February 14, 2018

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) February 14, 2018

Registered at 12912 COLDWATER RD STE E, FORT WAYNE, IN 468458871 (Tel: 2602451455)

πŸ“
Business Mailing Address (Initial Record) February 14, 2018

Registered at 6060 N COLLEGE AVE, INDIANAPOLIS, IN 462201907 (Tel: 3175845166)

πŸ‘€
Provider Name / Credentials (Initial Record) February 14, 2018

Recorded as SAMUEL BARRETT

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 14, 2018

Behavior Technician

🟒
Initial NPI Registration & Enumeration February 14, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1568962777
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 14, 2018
Last Update: March 17, 2018
Sole Proprietor: No

Mailing Address

6060 N College Ave

Indianapolis, IN 462201907

Phone: 3175845166

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.