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BENJAMIN BOUBLI
NPI 1205593167
Physician Assistant in Brooklyn, NY

Active since November 25, 2021PECOS EnrolledAccepts Medicare Assignment
5902 18TH AVE, BROOKLYN, NY 11204(347) 625-7557 Get Directions Write a Review

NPPES record last updated: January 25, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 25, 2023, Oct 27, 2022, Nov 25, 2021 (3 updates tracked since 2021).

About Benjamin Boubli NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BENJAMIN BOUBLI (NPI 1205593167) is an individual physician assistant in Brooklyn, New York, licensed in New York (027638) and active in the NPI registry since November 2021. He is enrolled in Medicare PECOS, maintains a secondary practice location in Brooklyn, and is a graduate of State University Of New York Downstate Medical Center (2021).

NPPES Registry Identity

NPI1205593167
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameBENJAMIN BOUBLI
Location Address5902 18TH AVEBrooklyn, NY 11204-2201
Mailing Address670 Hawthorne StBrooklyn, NY 11203-1804
Phone(347) 625-7557
Sole ProprietorYes
Medical School CMSState University Of New York Downstate Medical CenterGraduated 2021
Enumeration DateNovember 25, 2021
Last NPPES UpdateJanuary 25, 20233 updates tracked since enumeration
NPPES CertifiedJanuary 25, 2023
✔ NPI 1205593167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NY · 027638
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
5902 18TH AVE, Brooklyn, NY 11204
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Secondary Practice Location 1

Location 1667 Myrtle AveBrooklyn, NY 11205-4180 · Phone (347) 625-7557

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Benjamin Boubli is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8628444163
PECOS Enrollment IDI20221025000392
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11204 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Benjamin Boubli's NPI number?

The NPI number for Benjamin Boubli is 1205593167. It was assigned to this individual provider in the NPPES registry on November 25, 2021.

Where is Benjamin Boubli located?

Benjamin Boubli practices at 5902 18th Ave, Brooklyn, NY 11204. The listed phone number is (347) 625-7557.

What is Benjamin Boubli's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Benjamin Boubli enrolled in Medicare?

Yes. Benjamin Boubli is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Benjamin Boubli was last updated on January 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.