NPIMap

Individual provider Active NPI

Mustafa Imran

  • Family Medicine Physician
  • Williamsport, PA
National Provider Identifier
1528268026
Registry record updated Jan 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD449180 Issued in PA
Practice address
700 High St
Williamsport, PA 17701-3198
Phone
(570) 321-2850
Fax
(570) 321-2851
NPI assigned
Jul 23, 2007
Last updated
Jan 31, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60085884 WA
Family Medicine Physician 207Q00000X MD449180 PA Primary

Addresses

Primary practice location

700 High St
Williamsport, PA 17701-3198

Mailing address

1201 Grampian Blvd
Suite 1K
Williamsport, PA 17701-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ, MI3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20131119000513 PA Practitioner - General SurgeryPractitioner - Family Practice 4082764782 Reassigns benefits to 2 organizations
I20150302000635 NJ Practitioner - Family Practice 4082764782 Reassigns benefits to 1 organization
I20250716000381 MI Practitioner - Family Practice 4082764782 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians
Grand Traverse Physician Services PCGroup PAC ID 2466963806, 119 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60085884WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Jan 28, 2015 Accepting new patients
Geisinger Clinic CurrentSince Sep 17, 2013 Accepting new patients
Otsego Physician Services PC CurrentSince Jul 1, 2025 Accepting new patients
Geisinger Clinic Family Medicine Current Accepting new patients
Pennsylvania Hospitalist Group, LLC CurrentSince Sep 1, 2024 Accepting new patients
Geisinger Clinic CurrentSince Sep 17, 2013 Accepting new patients
Wexford Physician Services PC Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Grand Traverse Physician Services PC Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Summit Medical Group PA CurrentSince Jan 28, 2015 Accepting new patients
North Michigan Physician Services PC Family Medicine CurrentSince Jul 1, 2025 Accepting new patients

Locations

200 Corporate Blvd
Lafayette, LA 70508

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

14700 Lake Shore Dr
Charlevoix, MI 49720
Phone (231) 547-3840

825 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

100 N Academy Ave
Danville, PA 17822

746 Jefferson Ave
Scranton, PA 18510
Phone (570) 340-5079

575 N River St
Wilkes Barre, PA 18764
Phone (570) 552-1300

Interoperability endpoints

  • Direct secure messaging: mimran241791@epicdirect.rwjbh.org
  • Direct secure messaging: mustafa.imran.1@2983.direct.athenahealth.com

Organizations & group practices 10

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

Hospital & facility affiliations 9

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": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391126400000",
    "number": "1528268026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "address_2": "SUITE 1K",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 HIGH ST",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177013198",
            "telephone_number": "570-321-2850",
            "fax_number": "570-321-2851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMRAN",
        "first_name": "MUSTAFA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-23",
        "last_updated": "2014-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60085884",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD449180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.