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SAMANTHA E BOUSTANI MD
NPI 1700413044
Internal Medicine in Lodi, NJ

Active since March 26, 2020PECOS EnrolledAccepts Medicare Assignment
160 ESSEX ST, STE 102, LODI, NJ 07644(551) 996-8111 Get Directions Write a Review

NPPES record last updated: January 23, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 23, 2026, Mar 26, 2020 (2 updates tracked since 2020).

About Samantha E Boustani Md NPPES

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

SAMANTHA E BOUSTANI MD (NPI 1700413044) is an individual internal medicine provider in Lodi, New Jersey, licensed in New Jersey (25MA12210800) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS, is affiliated with Hackensack University Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1700413044
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameSAMANTHA E BOUSTANICredential: MD
Location Address160 ESSEX ST, STE 102Lodi, NJ 07644-2709
Mailing Address331 Newman Springs Rd, Bldg 2, Ste 220Red Bank, NJ 07701-5688
Phone(551) 996-8111
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateMarch 26, 2020
Last NPPES UpdateJanuary 23, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 23, 2026
✔ NPI 1700413044 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NJ · 25MA12210800
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedInternal Medicine · Sports MedicineTaxonomy 207RS0010X · License 25MA12210800 (NJ)
160 ESSEX ST, Lodi, NJ 07644
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Secondary Practice Locations 2

Location 14 Hunter St, Ste 203Lodi, NJ 07644-1608 · Phone (551) 996-9100
Location 230 Prospect AveHackensack, NJ 07601-1915 · Phone (551) 996-2000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

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

Samantha E Boustani Md 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 ID1759740236
PECOS Enrollment IDI20241118002530
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Hackensack University Medical Center

Acute Care Hospitals · Hackensack, NJ
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310001
Location30 Prospect AveHackensack, NJ 07601 · Bergen County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07644 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
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

DR. KHALED ABU IHWEIJ MD
Internal Medicine (Pulmonary Disease)
160 ESSEX ST, STE 103
LODI, NJ 07644
Bergen County (551) 996-1370

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 Samantha Boustani's NPI number?

The NPI number for Samantha Boustani is 1700413044. It was assigned to this individual provider in the NPPES registry on March 26, 2020.

Where is Samantha Boustani located?

Samantha Boustani practices at 160 Essex St Ste 102, Lodi, NJ 07644. The listed phone number is (551) 996-8111.

What is Samantha Boustani's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Samantha Boustani enrolled in Medicare?

Yes. Samantha Boustani 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.

What insurance does Samantha Boustani accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Samantha Boustani as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Samantha Boustani affiliated with any hospitals?

According to CMS data, Samantha Boustani is affiliated with Hackensack University Medical Center.

When was this NPI record last updated?

The NPPES record for Samantha Boustani was last updated on January 23, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.