Ben Boonstra, OTR/L
Individual provider Active NPI Occupational Therapist · Maywood, NJ
NPI 1508649641 · NPPES record last updated Aug 14, 2023
Key facts
- NPI
- 1508649641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 46TR01135800 (NJ)
- Practice address
- 119 E Passaic St
Maywood, NJ 07607-1342 - Phone
- (201) 880-7787
- NPI assigned
- Aug 14, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Maywood Physical Therapy LLC
Practice addresses (Care Compare)
119 E Passaic St
Maywood, NJ 07607-1342
Phone (201) 880-7787
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230927003680 | NJ | Practitioner - Occupational Therapist in Private Practice | 6406200294 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46TR01135800 | NJ | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paramus Physical Therapy and Rehabilitation LLC | Current |
Accepting new patients | |
| Bergenfield Physical Therapy & Rehab Center LLC | Current |
Accepting new patients | |
| Emerson Physical Therapy LLC | Current |
Accepting new patients | |
| Maywood Physical Therapy LLC | Current |
Accepting new patients | |
| Clifton Physical Therapy & Rehab Center LLC | Current |
Accepting new patients | |
| Town Chiropractor Paramus LLC | Occupational Therapist | Past | Accepting new patients |
Locations
253 S Washington Ave
Ste 1A
Bergenfield, NJ 07621
Phone (201) 338-4053
1373 Broad St
Ste 204
Clifton, NJ 07013
Phone (862) 249-1330
45 Emerson Plz E
Ste 102
Emerson, NJ 07630
Phone (201) 477-8415
119 E Passaic St
Maywood, NJ 07607
Phone (201) 880-7787
12 N State Rt 17
Ste 118
Paramus, NJ 07652
Phone (201) 535-4145
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 46TR01135800 | NJ | Yes |
Addresses
Primary practice location
119 E Passaic St
Maywood, NJ 07607-1342
Mailing address
119 E Passaic St
Maywood, NJ 07607-1342
Phone (201) 880-7787
Other providers in Maywood, NJ
- Patricia Betty
- Ivan Bilbao-Lavieja
- Anna Blazejowskyj
- Marissa Bocchiaro
- Bonleven Healthcare
- Borough of Maywood
- BTR Home Care LLC
- Brittany Franciska Bucko
- Andrea Calabro
- Matthew David Cannon
All providers in Maywood, NJ · Occupational Therapist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.