IDAN BOUSSANI DO
NPI 1255073045
Anesthesiology in Brooklyn, NY

Active since April 12, 2022PECOS Enrolled
450 CLARKSON AVE, BROOKLYN, NY 11203(718) 270-1984 Get Directions Write a Review

NPPES record last updated: February 11, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Idan Boussani Do NPPES

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

IDAN BOUSSANI DO (NPI 1255073045) is an individual anesthesiology provider in Brooklyn, New York, licensed in New York (341976) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1255073045
Entity TypeIndividualMale
Primary Taxonomy207L00000X
Provider Legal NameIDAN BOUSSANICredential: DO
Location Address450 CLARKSON AVEBrooklyn, NY 11203-2012
Mailing Address167 Cromwell Ave Apt 3cStaten Island, NY 10304-3950 · (718) 702-0542
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateApril 12, 2022
Last NPPES UpdateFebruary 11, 2026
NPPES CertifiedFebruary 11, 2026
NPI 1255073045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License Licensed in NY · 341976
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
450 CLARKSON AVE, Brooklyn, NY 11203

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Idan Boussani Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID345725404
PECOS Enrollment IDI20260327000314
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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Obstetrics & Gynecology
450 CLARKSON AVE
BROOKLYN, NY 11203
Internal Medicine (Gastroenterology)
450 CLARKSON AVE, SUITE A
BROOKLYN, NY 11203
Emergency Medicine
450 CLARKSON AVE
BROOKLYN, NY 11203
Student in an Organized Health Care Education/Training Program
450 CLARKSON AVE, SUNY DOWNSTATE MEDICAL CENTER
BROOKLYN, NY 11203
Internal Medicine (Pulmonary Disease)
450 CLARKSON AVE
BROOKLYN, NY 11203
Family Medicine
450 CLARKSON AVE, MSC 67
BROOKLYN, NY 11203
Emergency Medicine
450 CLARKSON AVE
BROOKLYN, NY 11203
Emergency Medicine
450 CLARKSON AVE
BROOKLYN, NY 11203

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 Idan Boussani's NPI number?

The NPI number for Idan Boussani is 1255073045. It was assigned to this individual provider in the NPPES registry on April 12, 2022.

Where is Idan Boussani located?

Idan Boussani practices at 450 Clarkson Ave, Brooklyn, NY 11203. The listed phone number is (718) 270-1984.

What is Idan Boussani's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Idan Boussani enrolled in Medicare?

Yes. Idan Boussani is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Idan Boussani was last updated on February 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.