Hossam Idrissi Boucteb

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P21044 Issued in NC

Practice address

4109 Wake Forest Rd Ste 200
Raleigh, NC 27609-6262

Phone

(919) 322-0042

Fax

(919) 322-0041

NPI assigned

Feb 25, 2022

Sex

Male

Sole proprietor

No

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

Enrolled in NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of North Carolina Hospitals at Chapel HillGroup PAC ID 4486561008, 110 clinicians

Activcare Physical Therapy, LLCGroup PAC ID 8628027471, 126 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.67 of 100Reported as group

Quality

85.21

Promoting interoperability

99

Improvement activities

40

Cost

77.85

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hossam.boucteb.p12@direct.athleticoltd.nextgenshare.com

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.

• Activcare Physical Therapy, LLC

  • Clinic/Center
  • Raleigh, NC
  • NPI 1548409626

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• University of North Carolina Hospitals at Chapel Hill

  • Interventional Cardiology Physician
  • Chapel Hill, NC
  • NPI 1568070308
  Medicare reassignment Care Compare group
• University of North Carolina Hospitals at Chapel Hill

  • Community/Retail Pharmacy
  • Morrisville, NC
  • NPI 1134928542
  NPD
• University of North Carolina Hospitals at Chapel Hill

  • Physical Therapist
  • Chapel Hill, NC
  • NPI 1245633387
  NPD
• University of North Carolina Hospitals at Chapel Hill

  • Pharmacy
  • Chapel Hill, NC
  • NPI 1205840857
  NPD (past)
• University of North Carolina Hospitals at Chapel Hill

  • Pediatric Nutrition Registered Dietitian
  • Chapel Hill, NC
  • NPI 1861415804
  NPD (past)

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1164178372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 HYANNIS DR",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275408331",
            "telephone_number": "919-633-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 WAKE FOREST RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096262",
            "telephone_number": "919-322-0042",
            "fax_number": "919-322-0041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5476 Apex Peakway",
            "address_purpose": "LOCATION",
            "city": "Apex",
            "state": "NC",
            "postal_code": "275023924",
            "country_code": "US",
            "telephone_number": "919-626-9799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUCTEB",
        "first_name": "HOSSAM",
        "middle_name": "IDRISSI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-25",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Dozier Bothma, LCSWA
• Samia Botros
• Jason Bottoms
• Gene Robert Botwright Jr.
• Natalie Rayne Boucher, MSW, LCSW
• Amanda N Boudreaux, MS, BCBA
• Alaa Bouhya
• Sasha Venyke Bouldin, LCSW-A
• Bryon Boulton, MD
• Lauren Maria Boulus, MS, RD, LDN

• Physical Therapist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.