Active NPI
Samia B Ayoub
- Pediatrics Physician
- Holmdel, NJ
National Provider Identifier
1376833848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MA064916
- Practice address
- 2080 Highway 35
Holmdel, NJ 07733-1090 - Phone
- (732) 671-0011
- Fax
- (732) 671-2564
- NPI assigned
- Apr 18, 2011
- Last updated
- Apr 18, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MA064916 | NJ | Primary |
Addresses
Primary practice location
2080 Highway 35
Holmdel, NJ 07733-1090
Mailing address
2080 Highway 35
Holmdel, NJ 07733-1090
Phone (732) 671-0011
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7386508 | Medicaid | NJ |
Other names 1
- Dr. Samia Botrous
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA064916 | NJ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocare , LLC | Pediatrics | Past | Accepting new patients |
| Miguelino and David Pediatric Associates,LLC | Pediatrics | Past | Accepting new patients |
| Ivy Pediatrics, PA | Pediatrics | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatrics Physician
- Holmdel, NJ
- NPI 1205914256
-
- Pediatrics Physician
- Manalapan, NJ
- NPI 1871660407
-
- Pediatrics Physician
- Holmdel, NJ
- NPI 1609019975
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303084800000",
"number": "1376833848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2080 HIGHWAY 35",
"city": "HOLMDEL",
"state": "NJ",
"postal_code": "077331090",
"telephone_number": "732-671-0011",
"fax_number": "732-671-2564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2080 HIGHWAY 35",
"city": "HOLMDEL",
"state": "NJ",
"postal_code": "077331090",
"telephone_number": "732-671-0011",
"fax_number": "732-671-2564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AYOUB",
"first_name": "SAMIA",
"middle_name": "B",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-18",
"last_updated": "2011-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "MA064916",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7386508",
"state": "NJ"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SAMIA",
"last_name": "BOTROUS",
"prefix": "DR.",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Holmdel, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.