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Deactivated NPI 1396826863 Deactivated / Inactive NPI Male Practitioner

Dr. Joseph Boodin , MD

Specialist • Upper Montclair, NJ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Joseph Boodin has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 18, 2006
NPI Deactivation Date June 19, 2025
Total Practice Duration ~19 Years of Practice (2006 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Joseph Boodin, MD was a registered Specialist practicing in Upper Montclair, NJ. Throughout an active medical career spanning 19 years, Dr. Boodin provided care at the practice location at 338 N MOUNTAIN AVE until profile deactivation on 2025-06-19.

Practice Location & Contact Primary Location

Practice Address

338 N Mountain Ave

Upper Montclair, NJ 070431020

Telephone 9737464641
Fax 9737462443

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Upper Montclair, NJ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 35.6 Yrs
Regional Practice Density
1 Specialists

Practicing in Upper Montclair, NJ (1802 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License NJ 25MA01674600

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 19, 2025

Record deactivated on June 19, 2025

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 338 N MOUNTAIN AVE, UPPER MONTCLAIR, NJ 070431020 (Tel: 9737464641)

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Updated Business Mailing Address July 08, 2007

Registered at 338 N MOUNTAIN AVE, PO BOX 43665, UPPER MONTCLAIR, NJ 070431020 (Tel: 9737464641)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JOSEPH BOODIN, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist (License #25MA01674600 in NJ)

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Initial NPI Registration & Enumeration October 18, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1396826863
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 18, 2006
Last Update: July 08, 2007
Deactivation Date: June 19, 2025

Mailing Address

338 N Mountain Ave, Po Box 43665

Upper Montclair, NJ 070431020

Phone: 9737464641

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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