NPIMap

Individual provider Active NPI

Jaylaine Ghoubrial, M.D.

  • Obstetrics Physician
  • Ephrata, PA
National Provider Identifier
1144293754
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
MD422153 Issued in PA
Practice address
175 Martin Ave Ste 125
Ephrata, PA 17522-1761
Phone
(717) 721-5700
Fax
(717) 721-5712
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X MD422153 PA Primary

Addresses

Primary practice location

175 Martin Ave Ste 125
Ephrata, PA 17522-1761

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 721-5700

Other identifiers 1

IdentifierTypeStateIssuer
101104746MedicaidPA

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
I20040510001048 PA Practitioner - Obstetrics/Gynecology 7315936895 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Temple University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

169 Martin Ave
Ephrata, PA 17522-1724
Phone (717) 733-0311

175 Martin Ave
Ephrata, PA 17522-1761

25 Monument Rd
York, PA 17403-5073

2618 E Market St
Autumn House
York, PA 17403
Phone (717) 845-7214

914 W Market St
Autumn House West
York, PA 17403
Phone (717) 845-7214

Hospital & facility affiliations

  • Wellspan Ephrata Community Hospital Hospital, Ephrata, PA, CCN 390225
  • Reading Hospital Hospital, West Reading, PA, CCN 390044
  • Wellspan York Hospital Hospital, York, PA, CCN 390046

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group CurrentSince Jul 1, 2003 Accepting new patients
Tower Health Medical Group CurrentSince Jul 1, 2003 Accepting new patients
Wellspan Medical Group CurrentSince May 2, 2022 Accepting new patients
Wellspan Medical Group CurrentSince May 2, 2022 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Ephrata Community Hospital Past Accepting new patients

Locations

175 Martin Ave
Ste 125
Ephrata, PA 17522
Phone (717) 812-4602

169 Martin Ave
Ephrata, PA 17522
Phone (717) 733-0311

6 Spruce St
West Reading, PA 19611
Phone (484) 628-8269

301 S 7th Ave
Ste 245
West Reading, PA 19611
Phone (484) 628-7900

1040 Reed Ave
#4
Wyomissing, PA 19610
Phone (610) 898-7560

950B N Wyomissing Blvd
Wyomissing, PA 19610
Phone (610) 898-1820

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

Interoperability endpoints

  • Direct secure messaging: jghoubrial298949@wellspan.direct-ci.com

Organizations & group practices 7

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1144293754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-721-5700",
            "fax_number": "717-721-5712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MARTIN AVE STE 125",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221761",
            "telephone_number": "717-721-5700",
            "fax_number": "717-721-5712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOUBRIAL",
        "first_name": "JAYLAINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "PA",
            "license": "MD422153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101104746",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ephrata, PA

Sources for this page

Verify at the official NPI Registry.