Individual provider Active NPI

Selma Sadik Mustafa, PA

  • Physician Assistant
  • Hanover, MD
National Provider Identifier
1255809976
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C07012 Issued in MD
Practice address
7467 Ridge Rd Ste 140
Hanover, MD 21076-3118
Phone
(410) 768-5050
Fax
(410) 768-7830
NPI assigned
Nov 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C07012 MD Primary

Addresses

Primary practice location

7467 Ridge Rd Ste 140
Hanover, MD 21076-3118

Mailing address

7467 Ridge Rd Ste 140
Hanover, MD 21076-3118
Phone (410) 768-5050

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address selma.mustafa.1@6309.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190102000044 MD Practitioner - Physician Assistant 8224373816 Reassigns benefits to 1 organization
I20240715002560 NY Practitioner - Physician Assistant 8224373816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

46 Brentwood Rd
Bay Shore, NY 11706-6924
Phone (631) 587-1800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
87.93 of 100Reported as group
Quality
86.7
Promoting interoperability
100
Improvement activities
40
Cost
73.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C07012MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC CurrentSince Nov 6, 2018 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Nov 6, 2018 Accepting new patients
Medical Services of Kips Bay PC Past Accepting new patients

Locations

1630 Main St
Ste 108
Chester, MD 21619
Phone (410) 643-3410

10710 Charter Dr
Ste 300
Columbia, MD 21044
Phone 4106441880450

1600 Crain Hwy S
Ste 401
Glen Burnie, MD 21061
Phone (410) 768-5050

7467 Ridge Rd
Ste 140
Hanover, MD 21076
Phone (410) 768-5050

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11237/brand/1/csg/1/fhir/r4
  • Direct secure messaging: 32smustafa@cfaortho.emadirect.md
  • Direct secure messaging: selmamustafa@nslijmedgr.allscriptsdirect.net

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 3

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": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1255809976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7467 RIDGE RD STE 140",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210763118",
            "telephone_number": "410-768-5050",
            "fax_number": "410-768-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7467 RIDGE RD STE 140",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210763118",
            "telephone_number": "410-768-5050",
            "fax_number": "410-768-7830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTAFA",
        "first_name": "SELMA",
        "middle_name": "SADIK",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-12",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C07012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "selma.mustafa.1@6309.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1600 Crain Hwy S Ste 401",
            "city": "Glen Burnie",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210616413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hanover, MD

Sources for this page

Verify at the official NPI Registry.