KASSIDY SANDY-BOURNE
NPI 1861977449
Behavior Technician in Melville, NY

Active since September 28, 2018PECOS EnrolledAccepts Medicare Assignment
225 BROADHOLLOW RD STE 402, MELVILLE, NY 11747(631) 385-7780(613) 385-7795 Get Directions Write a Review

NPPES record last updated: July 9, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 9, 2021, Sep 28, 2018 (2 updates tracked since 2018).

About Kassidy Sandy-bourne NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KASSIDY SANDY-BOURNE (NPI 1861977449) is an individual behavior technician in Melville, New York and active in the NPI registry since September 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1861977449
Entity TypeIndividualFemale
Primary Taxonomy106S00000X
Provider Legal NameKASSIDY SANDY-BOURNE
Location Address225 BROADHOLLOW RD STE 402Melville, NY 11747-4899
Mailing Address225 Broadhollow Rd Ste 205Melville, NY 11747-4822 · (631) 385-7780 · Fax (631) 385-7795
Fax(613) 385-7795
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateSeptember 28, 2018
Last NPPES UpdateJuly 9, 20212 updates tracked since enumeration
NPPES CertifiedJuly 9, 2021
✔ NPI 1861977449 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyBehavior TechnicianBehavioral Health & Social Service Providers
Taxonomy Code106S00000X
Definition
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.
Also ListedSocial WorkerTaxonomy 104100000X
225 BROADHOLLOW RD STE 402, Melville, NY 11747

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kassidy Sandy-bourne is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID143784439
PECOS Enrollment IDI20260708001536
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Kassidy Sandy-bourne reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Clinical
2433 KNAPP ST STE 306
Brooklyn, NY 11235
  • Reassigned Medicare billing, New York enrollment
  • 436 clinicians in this Medicare group
Clinical
300 CADMAN PLZ W
Brooklyn, NY 11201
  • Reassigned Medicare billing, New York enrollment
  • 457 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Behavior Analyst
225 BROADHOLLOW RD STE 402
MELVILLE, NY 11747
Behavior Analyst
225 BROADHOLLOW RD STE 402
MELVILLE, NY 11747
Behavior Technician
225 BROADHOLLOW RD STE 402
MELVILLE, NY 11747
Behavior Technician
225 BROADHOLLOW RD STE 402
MELVILLE, NY 11747
Behavior Technician
225 BROADHOLLOW RD STE 402
MELVILLE, NY 11747
Behavior Technician
225 BROADHOLLOW RD STE 402
MELVILLE, NY 11747
Specialist
225 BROADHOLLOW RD STE 402
MELVILLE, NY 11747
Behavior Technician
225 BROADHOLLOW RD STE 402
MELVILLE, NY 11747

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kassidy Sandy-bourne's NPI number?

The NPI number for Kassidy Sandy-bourne is 1861977449. It was assigned to this individual provider in the NPPES registry on September 28, 2018.

Where is Kassidy Sandy-bourne located?

Kassidy Sandy-bourne practices at 225 Broadhollow Rd Ste 402, Melville, NY 11747. The listed phone number is (631) 385-7780.

What is Kassidy Sandy-bourne's specialty?

The primary specialty registered for this NPI is Behavior Technician with taxonomy code 106S00000X.

Is Kassidy Sandy-bourne enrolled in Medicare?

Yes. Kassidy Sandy-bourne is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kassidy Sandy-bourne's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kassidy Sandy-bourne reassigns Medicare benefits to 2 organizations: Knapp Street Psychiatry, PC (Brooklyn, NY) and Che Senior Psychological Services, PC (Brooklyn, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kassidy Sandy-bourne's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kassidy Sandy-bourne accept?

Health plans from Oscar Health list Kassidy Sandy-bourne as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kassidy Sandy-bourne was last updated on July 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.