Individual provider Active NPI

Susan Eileen Boggs, NP

  • Family Nurse Practitioner
  • Brick, NJ
National Provider Identifier
1225029903
Registry record updated May 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NN08382300 Issued in NJ
Practice address
459 Jack Martin Blvd
Ste 1
Brick, NJ 08724-7724
Phone
(732) 785-1000
Fax
(732) 785-1222
NPI assigned
Nov 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NN08382300 NJ Primary

Addresses

Primary practice location

459 Jack Martin Blvd
Ste 1
Brick, NJ 08724-7724

Mailing address

459 Jack Martin Blvd
Ste 1
Brick, NJ 08724-7724
Phone (732) 785-1000

Other identifiers 1

IdentifierTypeStateIssuer
823410801MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20100927001074 NJ Practitioner - Nurse Practitioner 7719003854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Patient Care LLCGroup PAC ID 4981699451, 6 clinicians

Practice addresses (Care Compare)

459 Jack Martin Blvd
Brick, NJ 08724-7724
Phone (732) 785-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NN08382300NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Total Patient Care LLC CurrentSince Feb 1, 2002 Accepting new patients

Locations

459 Jack Martin Blvd
Ste 6
Brick, NJ 08724
Phone (732) 785-1000

459 Jack Martin Blvd
Ste 1
Brick, NJ 08724
Phone (732) 785-1000

Interoperability endpoints

  • Direct secure messaging: susan.boggs@totalpatientcare.chartmakerdirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274227200000",
    "number": "1225029903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 JACK MARTIN BLVD",
            "address_2": "STE 1",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247724",
            "telephone_number": "732-785-1000",
            "fax_number": "732-785-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 JACK MARTIN BLVD",
            "address_2": "STE 1",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247724",
            "telephone_number": "732-785-1000",
            "fax_number": "732-785-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGS",
        "first_name": "SUSAN",
        "middle_name": "EILEEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2010-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NN08382300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "823410801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.