Idan Boussani, DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

341976 Issued in NY

Practice address

450 Clarkson Ave
Brooklyn, NY 11203-2012

Phone

(718) 270-1984

NPI assigned

Apr 12, 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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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.

• North Shore - Lij Anesthesiology, PC

  • Anesthesiology Physician
  • Chappaqua, NY
  • NPI 1417401266
  Medicare reassignment

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1255073045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 CROMWELL AVE APT 3C",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043950",
            "telephone_number": "718-702-0542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-1984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUSSANI",
        "first_name": "IDAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-12",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "341976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Bouskila, MS ED/SPED
• Eden Tamar Bouskila
• Joseph Bouskila
• Muhammad Fouad Bouso, MD
• Janelle Bousquet, MA
• Fritz Boutin, MD
• Nadine Boutin
• Rose Boutin, RN
• Majdeline Boutros, RPH
• Sabrina Boutros, PA-C

• Anesthesiology Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Anesthesiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; 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.
• 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.