Farid Boualam, PT, DPT, CSCS
NPI 1407384209ActiveIndividual· Physical Therapist· Draper, UT
Physical Therapist (PT, DPT, CSCS) in Draper, Utah, licensed in MD and VT, with an NPI issued in May 2017.
Overview
| NPI | 1407384209 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT, DPT, CSCS |
| Sole proprietor | Yes |
| NPI issued | May 24, 2017 |
| Last updated in NPPES | May 30, 2023 |
| Certified by provider | May 30, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 26485 | MD |
| Physical Therapist | 225100000X | 040.0134584 | VT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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