NPIMap

Organization Active NPI

Waynesboro Hospital

Doing business as WellSpan Waynesboro

  • Clinic/Center
  • Waynesboro, PA
National Provider Identifier
1083780894
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
234301 Issued in PA
Legal business name
WAYNESBORO HOSPITAL
Doing business as
WellSpan Waynesboro
Practice address
501 E Main St
Short Procedure Unit Outpatient
Waynesboro, PA 17268-2353
Phone
(717) 765-4000
NPI assigned
Nov 27, 2006
Last updated
Mar 3, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
WAYNESBORO HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Laura Buczkowski
Title
Sr VP and Cfo
Phone
(410) 442-3373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 234301 PA Primary

Addresses

Primary practice location

501 E Main St
Short Procedure Unit Outpatient
Waynesboro, PA 17268-2353

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Other identifiers 1

IdentifierTypeStateIssuer
1007424870019MedicaidPA

Other names 1

  • WellSpan Waynesboro Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071203000478 PA Part A Provider - Hospital 6305830936 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fayetteville, PA; Greencastle, PA; Waynesboro, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083780894. Details of each certification follow.

Hospital certification: CCN 390138

Legal name
WAYNESBORO HOSPITAL
Doing business as
WELLSPAN WAYNESBORO HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 12, 2017
Beds
57 (47 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Sep 28, 1920 in PA
Enrollment address
501 E Main St
Waynesboro, PA 17268-2353
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Wellspan Waynesboro HospitalCCN 390138 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Anesthesia and Pain MNGT5 organizations share this tax ID, including this one
Part of
Anesthesia and Pain MNGT

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

501 E Main St
Unit Outpatient
Waynesboro, PA 17268
Phone (717) 765-4000

Ownership & related parties

All disclosed owners & managing parties 19

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Laura Buczkowski Individual Corporate OfficerSr VP and Cfo Nov 30, 2020
W-2 Managing EmployeeSr VP and Cfo Nov 30, 2020
Roxanna L Gapstur Individual Other Jan 2, 2019
Edward J Mackle Individual Corporate DirectorBoard Member Jan 1, 2021
Horace F Martin Individual Corporate DirectorBoard Member Jan 1, 2021
David a Doud Individual Corporate DirectorBoard Member Jan 1, 2021
Edward T Schuurman Individual Corporate OfficerDirector Jan 1, 2023
Corporate DirectorDirector Jan 1, 2023
Lissa Hinckle Individual Corporate DirectorEx Officio (Voting) Jan 1, 2025
Julianne Craig Individual Corporate DirectorBoard Member Jan 1, 2022
Michael B Seim Individual Corporate DirectorBoard Member Ex-Officio Jan 1, 2021
David Lovett Individual Corporate DirectorBoard Member Jan 1, 2022
Patricia Green-Rodgers Individual Corporate DirectorBoard Member Jan 1, 2022
Cheryl Plummer Individual Corporate OfficerChair Jan 1, 2021
Corporate DirectorChair Jan 1, 2021
Monica Mata Campos Individual Corporate DirectorBoard Member Jan 1, 2024
Roy Happel Individual Corporate OfficerDirector Jan 1, 2023
Corporate DirectorDirector Jan 1, 2023
Wellspan Health Organization, York, PA Corporation, Non-profit Operational/Managerial Control Nov 1, 2018
Other Nov 1, 2018
Stephen J Holoviak Individual Corporate DirectorBoard Member Jul 29, 2019
Wellspan Summit Health Organization, Chambersburg, PA Corporation, Non-profit Operational/Managerial Control Feb 9, 1995
Other Feb 9, 1995
Denis Onieal Individual Corporate OfficerVice Chair Jan 1, 2021
Corporate DirectorVice Chair Jan 1, 2021
Melissa Dubrow Individual Corporate OfficerPresident of Waynesboro Hospital Sep 1, 2020
W-2 Managing Employee Jan 1, 2020

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 628

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 628

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1083780894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E MAIN ST",
            "address_2": "SHORT PROCEDURE UNIT OUTPATIENT",
            "city": "WAYNESBORO",
            "state": "PA",
            "postal_code": "172682353",
            "telephone_number": "717-765-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNESBORO HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAYNESBORO HOSPITAL",
        "enumeration_date": "2006-11-27",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "BUCZKOWSKI",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "SR VP AND CFO",
        "authorized_official_telephone_number": "410-442-3373"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PA",
            "license": "234301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007424870019",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "WellSpan Waynesboro",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WellSpan Waynesboro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waynesboro, PA

Sources for this page

Verify at the official NPI Registry.