Individual provider Active NPI

Paul A Botros, MD

  • Family Medicine Physician
  • Lebanon, PA
National Provider Identifier
1760724074
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD459527 Issued in PA
Practice address
30 N 4TH St
2ND Floor
Lebanon, PA 17046-5606
Phone
(717) 274-0474
NPI assigned
Mar 25, 2013
Last updated
May 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD459527 PA Primary

Addresses

Primary practice location

30 N 4TH St
2ND Floor
Lebanon, PA 17046-5606

Mailing address

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

Other practice location 1

1401 Roosevelt Ave
York, PA 17404-2244
Phone (717) 812-7000

Other practice location 2

55 N Main St
Jacobus, PA 17407-1248
Phone (717) 428-1911

Other practice location 3

25 Monument Rd Ste 140
York, PA 17403-5057
Phone (717) 741-8003

Other practice location 4

54 S Forrest St
York, PA 17404-5550
Phone (717) 792-1811

Other practice location 5

300 Willow St
Lebanon, PA 17046-4871
Phone (717) 356-2222

Other practice location 6

2003 Springwood Rd
York, PA 17403-4836
Phone (717) 851-2521

Other practice location 7

1575 Bannister St Ste 1
York, PA 17404-4946
Phone (717) 812-2000

Other practice location 8

720 Norman Dr
Lebanon, PA 17042-7481
Phone (717) 274-6657

Other practice location 9

101 Fairview Cir
Lebanon, PA 17042-9581
Phone (717) 279-7303

Other practice location 10

4020 Carlisle Rd
Dover, PA 17315-3508
Phone (717) 851-6400

Other practice location 11

430 N Main St
Spring Grove, PA 17362-1123
Phone (717) 851-6500

Other practice location 12

6 Perri Ave
Myerstown, PA 17067-3200
Phone (717) 949-6581

Other practice location 13

4050 N George St Ext
Dover, PA 17315-3508
Phone (717) 812-4240

Other practice location 14

130 Pine Grove Cmns
York, PA 17403-5151
Phone (717) 851-5736

Other practice location 15

1790 Old Trail Rd
Etters, PA 17319-9652
Phone (717) 938-6588

Other identifiers 1

IdentifierTypeStateIssuer
103219609MedicaidPA

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
I20161208000515 PA Practitioner - Family Practice 3173766623 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
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)

30 N 4TH St
2 Wellspan Family Medicine North Fourth STR
Lebanon, PA 17046-5606
Phone (717) 272-2940

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD459527PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Jun 19, 2017 Accepting new patients
Wellspan Medical Group Family Medicine CurrentSince Jun 19, 2017 Accepting new patients
Good Samaritan Physician Services CurrentSince Aug 11, 2025 Accepting new patients
Good Samaritan Physician Services Current Accepting new patients
Wellspan Medical Group Current Accepting new patients
Good Samaritan Physician Services CurrentSince Aug 11, 2025 Accepting new patients
Wellspan Medical Group Past Accepting new patients

Locations

1790 Old Trail Rd
Etters, PA 17319
Phone (717) 938-6588

55 N Main St
Jacobus, PA 17407
Phone (717) 428-1911

30 N 4th St
Lebanon, PA 17046
Phone (717) 270-1949

30 N 4th St
Fl 2
Lebanon, PA 17046
Phone (717) 272-2940

720 Norman Dr
Lebanon, PA 17042
Phone (717) 279-6700

844 Tuck St
Lebanon, PA 17042
Phone (717) 274-8875

6 Perri Ave
Myerstown, PA 17067
Phone (717) 949-6581

101 Fairview Cir
North Cornwall, PA 17042
Phone (717) 279-7303

430 N Main St
Spring Grove, PA 17362
Phone (717) 225-4884

130 Pine Grove Cmns
York, PA 17403
Phone (717) 851-5736

1401 Roosevelt Ave
York, PA 17404
Phone (717) 356-6250

1575 Bannister St
Ste 1
York, PA 17404
Phone (717) 812-2000

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

2003 Springwood Rd
York, PA 17403
Phone (717) 851-2521

25 Monument Rd
Ste 140
York, PA 17403
Phone (717) 741-8003

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

4020 Carlisle Rd
York, PA 17315
Phone (717) 812-4240

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

Interoperability endpoints

  • Direct secure messaging: pbotros92883@wellspan.direct-ci.com

Organizations & group practices 7

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 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": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1760724074",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 4TH ST",
            "address_2": "2ND FLOOR",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170465606",
            "telephone_number": "717-274-0474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Roosevelt Ave",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174042244",
            "country_code": "US",
            "telephone_number": "717-812-7000",
            "fax_number": "717-767-8985",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 N Main St",
            "address_purpose": "LOCATION",
            "city": "Jacobus",
            "state": "PA",
            "postal_code": "174071248",
            "country_code": "US",
            "telephone_number": "717-428-1911",
            "fax_number": "717-428-2519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 Monument Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174035057",
            "country_code": "US",
            "telephone_number": "717-741-8003",
            "fax_number": "717-461-7404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "54 S Forrest St",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174045550",
            "country_code": "US",
            "telephone_number": "717-792-1811",
            "fax_number": "717-553-1279",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Willow St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170464871",
            "country_code": "US",
            "telephone_number": "717-356-2222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2003 Springwood Rd",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174034836",
            "country_code": "US",
            "telephone_number": "717-851-2521",
            "fax_number": "717-260-3330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1575 Bannister St Ste 1",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174044946",
            "country_code": "US",
            "telephone_number": "717-812-2000",
            "fax_number": "717-812-2010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "720 Norman Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170427481",
            "country_code": "US",
            "telephone_number": "717-274-6657",
            "fax_number": "717-270-6615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Fairview Cir",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170429581",
            "country_code": "US",
            "telephone_number": "717-279-7303",
            "fax_number": "717-279-7471",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4020 Carlisle Rd",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "PA",
            "postal_code": "173153508",
            "country_code": "US",
            "telephone_number": "717-851-6400",
            "fax_number": "717-851-6410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "430 N Main St",
            "address_purpose": "LOCATION",
            "city": "Spring Grove",
            "state": "PA",
            "postal_code": "173621123",
            "country_code": "US",
            "telephone_number": "717-851-6500",
            "fax_number": "717-775-3435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6 Perri Ave",
            "address_purpose": "LOCATION",
            "city": "Myerstown",
            "state": "PA",
            "postal_code": "170673200",
            "country_code": "US",
            "telephone_number": "717-949-6581",
            "fax_number": "717-949-2816",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4050 N George St Ext",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "PA",
            "postal_code": "173153508",
            "country_code": "US",
            "telephone_number": "717-812-4240",
            "fax_number": "717-851-6410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 Pine Grove Cmns",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174035151",
            "country_code": "US",
            "telephone_number": "717-851-5736",
            "fax_number": "717-715-1298",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1790 Old Trail Rd",
            "address_purpose": "LOCATION",
            "city": "Etters",
            "state": "PA",
            "postal_code": "173199652",
            "country_code": "US",
            "telephone_number": "717-938-6588",
            "fax_number": "717-938-9601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTROS",
        "first_name": "PAUL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-25",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD459527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103219609",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.