Individual provider Active NPI

Youssef Botros

  • Gastroenterology Physician
  • Fair Lawn, NJ
National Provider Identifier
1487068094
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25MA10006700 Issued in NJ
Practice address
22-02 Broadway Ste 301
Fair Lawn, NJ 07410-3016
Phone
(201) 414-5732
NPI assigned
Jun 12, 2014
Last updated
Dec 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 25MA10006700 NJ Primary

Addresses

Primary practice location

22-02 Broadway Ste 301
Fair Lawn, NJ 07410-3016

Mailing address

135 Jefferson Ave
Jersey City, NJ 07306-2128
Phone (201) 696-6503

Other practice location 1

703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-2000

Other identifiers 1

IdentifierTypeStateIssuer
0778460MedicaidNJ

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
I20210511000215 NJ Practitioner - Gastroenterology 6800205519 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

22 -02 Broadway
Suite 301
Fair Lawn, NJ 07410-3016
Phone (201) 414-5732

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy74
Upper gastrointestinal (GI) endoscopy for acid reflux108

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Jersey ASC Associates, LLC CurrentSince Feb 19, 2024 Accepting new patients
Hudson MD Group CurrentSince Oct 1, 2022 Accepting new patients
Essex Gastroenterology Associates LLC Gastroenterology CurrentSince Jul 1, 2021 Accepting new patients
Medical Associates of Englewood, PC CurrentSince Feb 1, 2024 Accepting new patients
Donald J. Beggs, MD PA PastSince Jul 1, 2021 Accepting new patients
David W. Lee MD PA PastSince Feb 6, 2007 Accepting new patients

Locations

5 Franklin Ave
Ste 109
Belleville, NJ 07109
Phone (973) 751-1616

1060 Clifton Ave
Clifton, NJ 07013
Phone (973) 532-7899

1060 Clifton Ave
Fl 2
Clifton, NJ 07013
Phone (973) 532-7899

180 Engle St
Englewood, NJ 07631
Phone (201) 567-2050

22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016

1625 Anderson Ave
Ste 204
Fort Lee, NJ 07024
Phone (201) 224-0011

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

1225 McBride Ave
Ste 224
Woodland Park, NJ 07424
Phone (862) 261-5553

Interoperability endpoints

  • Direct secure messaging: youssef.botros@ega.directbygreenway.com

Organizations & group practices 6

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.

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": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1487068094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 JEFFERSON AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073062128",
            "telephone_number": "201-696-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22-02 BROADWAY STE 301",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103016",
            "telephone_number": "201-414-5732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 Main St",
            "address_purpose": "LOCATION",
            "city": "Paterson",
            "state": "NJ",
            "postal_code": "075032621",
            "country_code": "US",
            "telephone_number": "973-754-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTROS",
        "first_name": "YOUSSEF",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA10006700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0778460",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

Verify at the official NPI Registry.