NPIMap

Individual provider Active NPI

Salma Mustafa, M.D.

  • Internal Medicine Physician
  • Danville, PA
National Provider Identifier
1124211032
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD447557 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-1401
Phone
(570) 271-6164
Fax
(570) 271-6141
NPI assigned
Aug 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD447557 PA Primary
Internal Medicine Physician 207R00000X 2007023621 MO

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-1401

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other identifiers 1

IdentifierTypeStateIssuer
1028189690001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130531000267 PA Practitioner - Internal Medicine 0042397390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wayne Memorial Community Health CentersGroup PAC ID 3072598937, 47 clinicians

Practice addresses (Care Compare)

1839 Fair Ave
Honesdale, PA 18431-2121
Phone (570) 251-6641

Hospital & facility affiliations

  • Personal Home Healthcare and Hospice Home health agency, Blakely, PA, CCN 398192
  • Wayne Memorial Hospital Hospital, Honesdale, PA, CCN 390125
  • Geisinger-Community Medical Center Hospital, Scranton, PA, CCN 390001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2007023621MOMDInternal Medicine Physician
MD447557PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Memorial Community Health Centers CurrentSince Aug 5, 2024 Accepting new patients
Wayne Memorial Community Health Centers Internal Medicine CurrentSince Aug 5, 2024 Accepting new patients

Locations

601 Park St
Honesdale, PA 18431
Phone (570) 253-8100

1839 Fair Ave
Honesdale, PA 18431
Phone (570) 251-6500

412 Como Rd
Lake Como, PA 18437
Phone (570) 775-7100

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455235200000",
    "number": "1124211032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178221401",
            "telephone_number": "570-271-6164",
            "fax_number": "570-271-6141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTAFA",
        "first_name": "SALMA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-23",
        "last_updated": "2016-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD447557",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2007023621",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028189690001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.