Active NPI
Sharbel Boustani
- Occupational Therapist
- Hackensack, NJ
National Provider Identifier
1184308769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 46TR01105200
- Practice address
- 411 Hackensack Ave
Hackensack, NJ 07601-6328 - Phone
- (732) 802-7512
- NPI assigned
- Jun 14, 2023
- Last updated
- Jun 14, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 46TR01105200 | NJ | Primary |
Addresses
Primary practice location
411 Hackensack Ave
Hackensack, NJ 07601-6328
Mailing address
43 Daisy Dr
Egg Harbor Township, NJ 08234-6119
Phone (201) 937-3574
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
Lodi, NJ 07644
Phone (732) 991-2562
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46TR01105200 | NJ | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| At Home by Enhance Therapies LLC | Multi-Specialty | Current | Accepting new patients |
| Ready Set Rehab LLC | Multi-Specialty | Current | Accepting new patients |
Locations
411 Hackensack Ave
Ste 200
Hackensack, NJ 07601
Phone (732) 987-3833
400 Route 70
Lakewood, NJ 08701
Phone (732) 802-7512
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686700800000",
"number": "1184308769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 DAISY DR",
"city": "EGG HARBOR TOWNSHIP",
"state": "NJ",
"postal_code": "082346119",
"telephone_number": "201-937-3574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 HACKENSACK AVE",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076016328",
"telephone_number": "732-802-7512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUSTANI",
"first_name": "SHARBEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-06-14",
"last_updated": "2023-06-14",
"certification_date": "2023-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NJ",
"license": "46TR01105200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hackensack, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.