Individual provider Active NPI

Muhammad B Bostaji, M.D.

  • Pulmonary Disease Physician
  • Goshen, IN
National Provider Identifier
1609875046
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
01089891A Issued in IN
Practice address
200 High Park Ave
Goshen, IN 46526-4810
Phone
(574) 364-2888
Fax
(574) 364-2327
NPI assigned
Jul 19, 2005
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 01089891A IN Primary
Pulmonary Disease Physician 207RP1001X MD12302 RI

Addresses

Primary practice location

200 High Park Ave
Goshen, IN 46526-4810

Mailing address

PO Box 834
Goshen, IN 46527-0834
Phone (574) 364-2592

Other names 1

  • Dr. Sammy Bostaji Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address muhammad.bostaji@goshenhealthdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20230411002048 IN Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 9830096387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goshen Health System IncGroup PAC ID 4880598572, 135 clinicians

Practice addresses (Care Compare)

200 High Park Ave
Goshen, IN 46526-4810
Phone (574) 364-2888

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01089891AINMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Health System Inc Internal Medicine CurrentSince May 1, 2023 Accepting new patients
Goshen Health System Inc CurrentSince May 1, 2023 Accepting new patients
Goshen Hospital Association Inc Current Accepting new patients

Locations

200 High Park Ave
Goshen, IN 46526
Phone (219) 533-2141

Organizations & group practices 3

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 1

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1609875046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 834",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465270834",
            "telephone_number": "574-364-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HIGH PARK AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264810",
            "telephone_number": "574-364-2888",
            "fax_number": "574-364-2327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTAJI",
        "first_name": "MUHAMMAD",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01089891A",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "RI",
            "license": "MD12302",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "muhammad.bostaji@goshenhealthdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "200 High Park Ave",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465264810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SAMMY",
            "last_name": "BOSTAJI",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Goshen, IN

Sources for this page

Verify at the official NPI Registry.