Individual provider Active NPI

Golam Mostofa, MD

  • Hospitalist Physician
  • Chambersburg, PA
National Provider Identifier
1174725329
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD432142 Issued in PA
Practice address
112 N 7TH St
Chambersburg, PA 17201-1720
Phone
(717) 217-4300
Fax
(717) 217-4217
NPI assigned
Jun 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD432142 PA Primary
Internal Medicine Physician 207R00000X MD432142 PA

Addresses

Primary practice location

112 N 7TH St
Chambersburg, PA 17201-1720

Mailing address

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

Other practice location 1

501 E Main St
Waynesboro, PA 17268-2353
Phone (717) 765-4000

Other practice location 2

252 S 4th St
Lebanon, PA 17042-6111
Phone (717) 270-4876

Other identifiers 1

IdentifierTypeStateIssuer
102023150 0002MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070815000024 PA Practitioner - HospitalistPractitioner - Internal Medicine 4183715576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1989
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)

112 N 7TH St
Chambersburg, PA 17201-1720
Phone (717) 267-7164

25 Monument Rd
York, PA 17403-5073

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

501 E Main St
Waynesboro, PA 17268-2353

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

Hospital & facility affiliations

  • Wellspan Chambersburg Hospital Hospital, Chambersburg, PA, CCN 390151
  • Wellspan Waynesboro Hospital Hospital, Waynesboro, PA, CCN 390138
  • Wellspan York Hospital Hospital, York, PA, CCN 390046
  • Wellspan Waynesboro Hospital Nursing home, CCN 39U138

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Wellspan Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Waynesboro Hospital Past Accepting new patients
The Chambersburg Hospital Past Accepting new patients

Locations

112 N 7th St
Chambersburg, PA 17201
Phone (717) 217-4300

252 S 4th St
Lebanon, PA 17042
Phone (717) 270-7500

501 E Main St
Waynesboro, PA 17268
Phone (717) 765-3400

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

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

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

Interoperability endpoints

  • Direct secure messaging: gmostofa227708@wellspan.direct-ci.com

Organizations & group practices 5

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": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1174725329",
    "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",
            "fax_number": "717-851-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 N 7TH ST",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172011720",
            "telephone_number": "717-217-4300",
            "fax_number": "717-217-4217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 E Main St",
            "address_purpose": "LOCATION",
            "city": "Waynesboro",
            "state": "PA",
            "postal_code": "172682353",
            "country_code": "US",
            "telephone_number": "717-765-4000",
            "fax_number": "717-765-3669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "252 S 4th St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170426111",
            "country_code": "US",
            "telephone_number": "717-270-4876",
            "fax_number": "717-270-3875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSTOFA",
        "first_name": "GOLAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD432142",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD432142",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102023150 0002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chambersburg, PA

Sources for this page

Verify at the official NPI Registry.