Individual provider Active NPI

Sarag Aboujafar Boukhar, M.D

  • Anatomic Pathology & Clinical Pathology Physician
  • Iowa City, IA
National Provider Identifier
1639482284
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD-43247 Issued in IA
Practice address
200 Hawkins Dr
Department of Pathology
Iowa City, IA 52242-1009
Phone
(319) 384-9609
Fax
(319) 384-9613
NPI assigned
Jul 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD-43247 IA Primary

Addresses

Primary practice location

200 Hawkins Dr
Department of Pathology
Iowa City, IA 52242-1009

Mailing address

3 Executive Dr Ste 400
Somerset, NJ 08873-4007
Phone (732) 369-5994

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
I20211108000003 NJ Practitioner - Pathology 3375833429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Robert Wood Johnson PL
Rutgers Health RWJ Pathology
New Brunswick, NJ 08901-1928
Phone (732) 937-8651

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-43247IAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Aug 3, 2021 Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Aug 3, 2021 Accepting new patients

Locations

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

125 Paterson St
Ste 6140
New Brunswick, NJ 08901
Phone (732) 235-6230

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.

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": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1639482284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 EXECUTIVE DR STE 400",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088734007",
            "telephone_number": "732-369-5994",
            "fax_number": "319-384-9613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-384-9609",
            "fax_number": "319-384-9613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUKHAR",
        "first_name": "SARAG",
        "middle_name": "ABOUJAFAR",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-23",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IA",
            "license": "MD-43247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.