Brian Boland

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01904600 Issued in NJ

Practice address

615 Goodmans Xing
Clark, NJ 07066-2738

Phone

(732) 259-9468

NPI assigned

Nov 25, 2019

Last updated

Sep 21, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ferris Home Rehabilitation LLC

  • Physical Therapist
  • Clark, NJ
  • NPI 1831978600

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Coastal Home Rehabilitation, LLC

  • Multi-Specialty Clinic/Center
  • Belmar, NJ
  • NPI 1316236664
  Medicare reassignment NPD
• Mobile Therapy Services, Inc.

  • Physical Therapist
  • Ocean, NJ
  • NPI 1326495615

  Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1114563269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 GOODMANS XING",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070662738",
            "telephone_number": "732-259-9468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 GOODMANS XING",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070662738",
            "telephone_number": "732-259-9468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLAND",
        "first_name": "BRIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-25",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01904600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blossom Therapy and Wellness
• Bluefern Home Care LLC (FirstLight Home Care of Metuchen and Clark)
• Richard Howard Blum, M.D.
• Lawrence J Bock, PT
• Faye Bodenstein, ACSW
• Gary I. Borker, D.M.D.
• Stephen D Bosonac, DDS
• Samuel Fares Samuel Botros
• Brandon Macy
• Ian Alfonzo Brewer, DC

• Physical Therapist in Clark, NJ
• Providers in Clark, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.