NPIMap

Individual provider Active NPI

Olubukola Babalola, M.D.

  • Dermatology Physician
  • Chambersburg, PA
National Provider Identifier
1992118715
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD467971 Issued in PA
Practice address
12 St Paul Dr Ste 104
Chambersburg, PA 17201-1035
Phone
(717) 263-8463
Fax
(717) 263-1103
NPI assigned
Jun 9, 2014
Last updated
Jul 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD467971 PA Primary

Addresses

Primary practice location

12 St Paul Dr Ste 104
Chambersburg, PA 17201-1035

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 263-8463

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190919000958 PA Practitioner - Dermatology 3779821343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2014
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)

296 St Charles Way
Wellspan Dermatology
York, PA 17402-4648
Phone (717) 812-5050

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision22
Removal of skin lesions549
Removal or shaving of skin growth1-10
Skin biopsy291

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
294449NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Jul 29, 2019 Accepting new patients
Wellspan Medical Group CurrentSince Jul 29, 2019 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Alexander Rabinovich Medical PC PastSince Dec 23, 2018 Accepting new patients

Locations

12 St Paul Dr
Ste 104
Chambersburg, PA 17201
Phone (717) 217-6986

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

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

296 Saint Charles Way
York, PA 17402
Phone (717) 812-5050

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

Interoperability endpoints

  • Direct secure messaging: obabalola187503@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1992118715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-263-8463",
            "fax_number": "717-263-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ST PAUL DR STE 104",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172011035",
            "telephone_number": "717-263-8463",
            "fax_number": "717-263-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABALOLA",
        "first_name": "OLUBUKOLA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD467971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chambersburg, PA

Sources for this page

Verify at the official NPI Registry.