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DR. MUSTAFA S GARBADAWALA M.D.
NPI 1548294127
Internal Medicine in Mansfield, OH

Active since July 10, 2006PECOS EnrolledAccepts Medicare Assignment
24.8/100
CMS Quality Rating
465 NORTH HOME RD, MANSFIELD, OH 44906(419) 747-1601(419) 747-1610 Get Directions Write a Review

NPPES record last updated: March 3, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Mustafa S Garbadawala M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MUSTAFA S GARBADAWALA M.D. (NPI 1548294127) is an individual internal medicine provider in Mansfield, Ohio, licensed in Ohio (35073495) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Wooster Community Hospital, and is a graduate of Medical College Of Ohio (1999).

NPPES Registry Identity

NPI1548294127
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. MUSTAFA S GARBADAWALACredential: M.D.
Location Address465 NORTH HOME RDMansfield, OH 44906-2323
Mailing Address465 North Home RdMansfield, OH 44906-2323 · (419) 747-1601 · Fax (419) 747-1610
Phone(419) 747-1601
Fax(419) 747-1610
Sole ProprietorYes
Medical School CMSMedical College Of OhioGraduated 1999
Enumeration DateJuly 10, 2006
Last NPPES UpdateMarch 3, 2011
✔ NPI 1548294127 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in OH · 35073495
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
465 NORTH HOME RD, Mansfield, OH 44906
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Other Identifiers 3

Medicare UPINH05107OH
Medicare ID-Type UnspecifiedGA0892072OH
Medicaid2131231OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Mustafa S Garbadawala M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1658384284
PECOS Enrollment IDI20100427000021
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Mustafa Garbadawala reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Internal Medicine Associates Of Mid-Ohio Inc
Same address
Internal Medicine
465 NORTH HOME RD
Mansfield, OH 44906
  • Reassigned Medicare billing, Ohio enrollment
NPI 1417970922 (419) 747-1601

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
497 services172 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
200 services117 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
168 services161 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
156 services156 patients
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180
This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
27 services15 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Wooster Community Hospital

Acute Care Hospitals · Wooster, OH
5/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number360036
Location1761 Beall AvenueWooster, OH 44691 · Wayne County
Emergency services Birthing friendly

Ohiohealth Mansfield Hospital

Acute Care Hospitals · Mansfield, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360118
Location335 Glessner AvenueMansfield, OH 44903 · Richland County
Emergency services Birthing friendly

Avita Ontario

Acute Care Hospitals · Ontario, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360365
Location715 Richland MallOntario, OH 44906 · Richland County
Emergency services Birthing friendly

Galion Community Hospital

Critical Access Hospitals · Galion, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number361325
Location269 Portland Way SouthGalion, OH 44833 · Crawford County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44906 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

24.8/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0
Cost82.66

Referred Medical Equipment & Supplies CMS DME claims 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers21 claims32 services$5.98 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers27 claims27 services$83.07 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$32.13 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
2 suppliers17 claims4,488 services$0.03 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
1 supplier12 claims12 services$20.13 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
3 suppliers20 claims20 services$23.54 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

INTERNAL MEDICINE ASSOCIATES OF MID-OHIO INC
Internal Medicine
465 NORTH HOME RD
MANSFIELD, OH 44906
Richland County (419) 747-1601

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mustafa Garbadawala's NPI number?

The NPI number for Mustafa Garbadawala is 1548294127. It was assigned to this individual provider in the NPPES registry on July 10, 2006.

Where is Mustafa Garbadawala located?

Mustafa Garbadawala practices at 465 North Home Rd, Mansfield, OH 44906. The listed phone number is (419) 747-1601.

What is Mustafa Garbadawala's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Mustafa Garbadawala enrolled in Medicare?

Yes. Mustafa Garbadawala is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Mustafa Garbadawala's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mustafa Garbadawala reassigns Medicare benefits to Internal Medicine Associates Of Mid-Ohio Inc (Mansfield, OH). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mustafa Garbadawala's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mustafa Garbadawala accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 2 other insurers list Mustafa Garbadawala as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mustafa Garbadawala affiliated with any hospitals?

According to CMS data, Mustafa Garbadawala is affiliated with Wooster Community Hospital, Ohiohealth Mansfield Hospital, Avita Ontario and Galion Community Hospital.

When was this NPI record last updated?

The NPPES record for Mustafa Garbadawala was last updated on March 3, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.