Individual provider Active NPI

Sarah Boddeus

  • Family Nurse Practitioner
  • Succasunna, NJ
National Provider Identifier
1710340989
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01079500 Issued in NJ
Practice address
66 Sunset Strip Ste 407
Succasunna, NJ 07876-1362
Phone
(973) 252-1676
NPI assigned
Apr 4, 2016
Last updated
Jan 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ01079500 NJ Primary

Addresses

Primary practice location

66 Sunset Strip Ste 407
Succasunna, NJ 07876-1362

Mailing address

1643 NW 136TH Ave
Sunrise, FL 33323-3091
Phone (954) 377-2939

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210114001468 NJ Practitioner - Nurse Practitioner 7012320914 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ01079500NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CS Pacs 3 Northeast, LLC CurrentSince Jan 13, 2025 Accepting new patients
Northwest Medical Care, LLC CurrentSince Nov 30, 2020 Accepting new patients
New Jersey Post Acute Medical Services 1 PA CurrentSince Jan 13, 2025 Accepting new patients
NJ Pacs 2 PA CurrentSince Jan 13, 2025 Accepting new patients

Locations

1643 NW 136th Ave
Sunrise, FL 33323
Phone (888) 447-2362

215 Madison Ave
Madison, NJ 07940
Phone (973) 301-0005

77 Madison Ave
Morristown, NJ 07960
Phone (973) 540-9800

95 Mount Kemble Ave
Morristown, NJ 07960
Phone (973) 971-4451

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

66 Sunset Strip
Ste 407
Succasunna, NJ 07876
Phone (973) 252-1166

1237 W Sherman Ave
Vineland, NJ 08360
Phone (856) 223-7718

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EFFCAA

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1710340989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 NW 136TH AVE",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333233091",
            "telephone_number": "954-377-2939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 SUNSET STRIP STE 407",
            "city": "SUCCASUNNA",
            "state": "NJ",
            "postal_code": "078761362",
            "telephone_number": "973-252-1676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODDEUS",
        "first_name": "SARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-04",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01079500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Succasunna, NJ

Sources for this page

Verify at the official NPI Registry.