Sarah Boujida, PA

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

026509 Issued in NY

Practice address

1174 Route 112
Port Jefferson Station, NY 11776-8033

Phone

(631) 642-9090

NPI assigned

Apr 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: sboujida132768@direct-chsli.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CHS Physician Partners, PC

  • Interventional Cardiology Physician
  • Fresh Meadows, NY
  • NPI 1407089345
  Medicare reassignment
• CHS Physician Partners, P.C

  • Cardiovascular Disease Physician
  • Roslyn, NY
  • NPI 1164585725
  NPD
• CHS Physician Partners, PC

  • Family Medicine Physician
  • Bellmore, NY
  • NPI 1720334527
  NPD
• Youthology Medical

  • Physician Assistant
  • Melville, NY
  • NPI 1235097064
  NPD

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1104409093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 45TH ST",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117572318",
            "telephone_number": "631-747-5587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 ROUTE 112",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117768033",
            "telephone_number": "631-642-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUJIDA",
        "first_name": "SARAH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "026509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "026509",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Ariel Bond, LPN
• Eileen Bordt, LPN
• Katie Melissa Born, M.A. CCC-CLP
• Varvara Boryushkina, MD
• Alexandra M Bosch
• Krista Bourne
• Kerri A Bove, SPECIAL EDUCATION TE
• John J Bowman, PH.D.
• Erin Nicole Brady
• Robyn Ann Brady

• Gastroenterology Physician in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.