Individual provider Active NPI

Nayab Mirza

  • Neurology Physician
  • Lebanon, PA
National Provider Identifier
1356911713
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD488451 Issued in PA
Practice address
958 Isabel Dr
Lebanon, PA 17042-7482
Phone
(717) 639-2978
NPI assigned
Jun 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD488451 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X MT222375 PA
Neurology Physician 2084N0400X FM5126265 PA

Addresses

Primary practice location

958 Isabel Dr
Lebanon, PA 17042-7482

Mailing address

PO Box 13579
Reading, PA 19612-3579
Phone (484) 628-1324

Other practice location 1

368 W Main St Ste 100
Leola, PA 17540-1761
Phone (717) 721-8789

Other practice location 2

207 W Fulton St
Ephrata, PA 17522-1902
Phone (717) 721-8789

Other practice location 3

420 S 5th Ave
West Reading, PA 19611-2143
Phone (484) 628-8000

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
I20250528000833 PA Practitioner - Neurology 4486056926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2018
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)

958 Isabel Dr
Lebanon, PA 17042-7482
Phone (717) 639-2978

Hospital & facility affiliations

  • Wellspan Good Samaritan Hospital Hospital, Lebanon, PA, CCN 390066
  • Wellspan Ephrata Community Hospital Hospital, Ephrata, PA, CCN 390225
  • Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD488451PAMDNeurology Physician
MT222375PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Jul 1, 2025 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Jul 1, 2025 Accepting new patients
Wellspan Medical Group Past Accepting new patients

Locations

207 W Fulton St
Ephrata, PA 17522
Phone (717) 721-8789

958 Isabel Dr
Lebanon, PA 17042
Phone (717) 639-2978

368 W Main St
#100
Leola, PA 17540
Phone (717) 656-6122

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: nmirza468412@wellspan.direct-ci.com

Organizations & group practices 4

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 8

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": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1356911713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-628-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "958 ISABEL DR",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427482",
            "telephone_number": "717-639-2978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "368 W Main St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Leola",
            "state": "PA",
            "postal_code": "175401761",
            "country_code": "US",
            "telephone_number": "717-721-8789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "207 W Fulton St",
            "address_purpose": "LOCATION",
            "city": "Ephrata",
            "state": "PA",
            "postal_code": "175221902",
            "country_code": "US",
            "telephone_number": "717-721-8789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "420 S 5th Ave",
            "address_purpose": "LOCATION",
            "city": "West Reading",
            "state": "PA",
            "postal_code": "196112143",
            "country_code": "US",
            "telephone_number": "484-628-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "NAYAB",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD488451",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT222375",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "FM5126265",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.