Individual provider Active NPI

Beau A Younker, OTR

  • Occupational Therapist
  • Rahway, NJ
National Provider Identifier
1356780258
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
46TR00407200 Issued in NJ
Practice address
1600 Saint Georges Ave
Suite 107
Rahway, NJ 07065-2764
Phone
(732) 428-5566
Fax
(732) 428-5513
NPI assigned
Jun 24, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 46TR00407200 NJ Primary

Addresses

Primary practice location

1600 Saint Georges Ave
Suite 107
Rahway, NJ 07065-2764

Mailing address

1600 Saint Georges Ave
Suite 107
Rahway, NJ 07065-2764
Phone (732) 428-5566

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130815000555 NJ Practitioner - Occupational Therapist in Private Practice 3173765427 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46TR00407200NJMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Holsman Physical and Occupational Therapy PC Occupational Therapist CurrentSince Jul 1, 2013 Accepting new patients

Locations

1070 Clifton Ave
Ste 1A
Clifton, NJ 07013
Phone (973) 246-6565

711 Kearny Ave
#2
Kearny, NJ 07032
Phone (201) 535-8555

1600 Saint Georges Ave
Ste 107
Rahway, NJ 07065
Phone (732) 428-5566

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1356780258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SAINT GEORGES AVE",
            "address_2": "SUITE 107",
            "city": "RAHWAY",
            "state": "NJ",
            "postal_code": "070652764",
            "telephone_number": "732-428-5566",
            "fax_number": "732-428-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SAINT GEORGES AVE",
            "address_2": "SUITE 107",
            "city": "RAHWAY",
            "state": "NJ",
            "postal_code": "070652764",
            "telephone_number": "732-428-5566",
            "fax_number": "732-428-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNKER",
        "first_name": "BEAU",
        "middle_name": "A",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00407200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rahway, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; 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.