Individual provider Active NPI

Leticia Santiago-Boston, APN

  • Nurse Practitioner
  • Woodbury, NJ
National Provider Identifier
1497101109
Registry record updated Dec 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ15475500 Issued in NJ
Practice address
22 N Broad St FL 2
Woodbury, NJ 08096-4603
Phone
(856) 436-0035
Fax
(833) 740-4280
NPI assigned
May 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ15475500 NJ Primary
Mental Health Counselor 101YM0800X 37AC00451100 NJ

Addresses

Primary practice location

22 N Broad St FL 2
Woodbury, NJ 08096-4603

Mailing address

22 N Broad St FL 2
Woodbury, NJ 08096-4603
Phone (856) 436-0035

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250922003990 NJ Practitioner - Mental Health Counselor 7810492840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Care Therapy LLCGroup PAC ID 0547335366, 140 clinicians

Practice addresses (Care Compare)

85 Crescent Ave
Passaic, NJ 07055-2437
Phone (973) 264-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37AC00451100NJMDMental Health Counselor
26NJ15475500NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Care Therapy LLC CurrentSince Jul 1, 2025 Accepting new patients
Sage Therapy Services LLC CurrentSince Dec 21, 2025 Accepting new patients

Locations

2719 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 354-2555

22 N Broad St
Fl 2
Woodbury, NJ 08096
Phone (856) 436-0035

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": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766188800000",
    "number": "1497101109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 N BROAD ST FL 2",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080964603",
            "telephone_number": "856-436-0035",
            "fax_number": "833-740-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 N BROAD ST FL 2",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080964603",
            "telephone_number": "856-436-0035",
            "fax_number": "833-740-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO-BOSTON",
        "first_name": "LETICIA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-11",
        "last_updated": "2025-12-20",
        "certification_date": "2025-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ15475500",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37AC00451100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

Verify at the official NPI Registry.