Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Idan Boussani, DO

Individual provider Anesthesiology Physician · NPI 1255073045

Idan Boussani, DO is an Anesthesiology in Brooklyn, New York. Qualified in 2022, 4 years ago. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2022
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone: (718) 270-1984
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 341976 (NY)

Record details

NPI number1255073045
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 12, 2022
Last updated in NPPESFebruary 11, 2026
Certification dateFebruary 11, 2026
Mailing address167 Cromwell Ave Apt 3c, Staten Island, NY 10304-3950

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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