Samantha E Boustani, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA12210800 Issued in NJ

Practice address

160 Essex St
Ste 102
Lodi, NJ 07644-2709

Phone

(551) 996-8111

NPI assigned

Mar 26, 2020

Last updated

Jan 23, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Internal Medicine

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hackensack Meridian Health Medical Group - Primary Care PCGroup PAC ID 7911003330, 364 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD
• FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/

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.

• Hackensack Meridian Health Medical Group - Primary Care PC

  dba HMHMG Primary Care

  • Family Medicine Physician
  • Red Bank, NJ
  • NPI 1336203538

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  dba HMMG New Jersey Oral & Maxillofacial Surgery

  • Durable Medical Equipment & Medical Supplies
  • North Bergen, NJ
  • NPI 1215734199
  NPD (past)
• Meridian Medical Group - Specialty Care, PC

  dba Hackensack Meridian Medical Group - One Medical PC

  • Family Medicine Physician
  • Edgewater, NJ
  • NPI 1275362105

  Internal Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HMH Hospitals Corporation

  dba Hackensack University Medical Center

  • General Acute Care Hospital
  • Hackensack, NJ
  • NPI 1457456279
  Care Compare affiliation
• HMH Hospitals Corporation

  dba Hackensack Meridian Diagnostic Laboratory

  • Clinical Medical Laboratory
  • Hackensack, NJ
  • NPI 1518683929

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1700413044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD",
            "address_2": "BLDG 2, STE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ESSEX ST",
            "address_2": "STE 102",
            "city": "LODI",
            "state": "NJ",
            "postal_code": "076442709",
            "telephone_number": "551-996-8111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Hunter St",
            "address_2": "Ste 203",
            "address_purpose": "LOCATION",
            "city": "Lodi",
            "state": "NJ",
            "postal_code": "076441608",
            "country_code": "US",
            "telephone_number": "551-996-9100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011915",
            "country_code": "US",
            "telephone_number": "551-996-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUSTANI",
        "first_name": "SAMANTHA",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA12210800",
            "primary": true
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "NJ",
            "license": "25MA12210800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Bertram, NP
• Beyond the Spectrum Therapeutic Center, Inc. (Enhanced Play)
• Tracy Biegel, LAC
• Blueren Health and Wellness, LLC
• James C Bonardi, MPT
• Bright Side Counseling & Psychotherapy
• Broadway Group Home LLC
• Broadway Respite and Home Care, LLC
• Alexa Buffington, PT, DPT
• Ana Mariel Builes, FNP-C

• Internal Medicine Physician in Lodi, NJ
• Providers in Lodi, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.