Individual provider Active NPI

Jeffrey R Boscamp, MD

  • Pediatric Infectious Diseases Physician
  • Hackensack, NJ
National Provider Identifier
1477563286
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
MA49878 Issued in NJ
Practice address
30 Prospect Ave
Dept of Pediatrics
Hackensack, NJ 07601-1914
Phone
(201) 996-5208
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X MA49878 NJ Primary

Addresses

Primary practice location

30 Prospect Ave
Dept of Pediatrics
Hackensack, NJ 07601-1914

Mailing address

30 Prospect Ave
Dept of Pediatrics
Hackensack, NJ 07601-1914

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070807000022 NJ Practitioner - Pediatric MedicinePractitioner - Infectious Disease 6103917158 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA49878NJMDPediatric Infectious Diseases Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2007 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2007 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477563286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "address_2": "DEPT OF PEDIATRICS",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "address_2": "DEPT OF PEDIATRICS",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011914",
            "telephone_number": "201-996-5208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSCAMP",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "NJ",
            "license": "MA49878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.