NPIMap

Organization Active NPI

Summit Ambulatory Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Towson, MD
National Provider Identifier
1003004482
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SUMMIT AMBULATORY SURGICAL CENTER, LLC
Practice address
6535 N Charles St Ste 625
Towson, MD 21204-5835
Phone
(410) 825-5454
Fax
(410) 825-5811
NPI assigned
Oct 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Authorized official

Name
Sara Bressman
Title
Authorized Official
Phone
(402) 779-6135

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

6535 N Charles St Ste 625
Towson, MD 21204-5835

Mailing address

25 Crossroads Dr
Suite 306
Owings Mills, MD 21117-5421
Phone (443) 738-2872

Other identifiers 1

IdentifierTypeStateIssuer
800906600MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051121000159 MD Part B Supplier - Ambulatory Surgical Center 1355360280 16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Baltimore, MD; Owings Mills, MD; Salisbury, MD; Westminster, MD; Annapolis, MD

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory

Locations

120 Sister Pierre Dr
Ste 102
Towson, MD 21204
Phone (410) 494-1402

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687737600000",
    "number": "1003004482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CROSSROADS DR",
            "address_2": "SUITE 306",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175421",
            "telephone_number": "443-738-2872",
            "fax_number": "443-738-2713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6535 N CHARLES ST STE 625",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212045835",
            "telephone_number": "410-825-5454",
            "fax_number": "410-825-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT AMBULATORY SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A",
        "authorized_official_last_name": "BRESSMAN",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "402-779-6135"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800906600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.