NPIMap

Organization Active NPI

Upper Chesapeake Surgical Associates, LLC

  • Surgical Physician Assistant
  • Bel Air, MD
National Provider Identifier
1003448606
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Legal business name
UPPER CHESAPEAKE SURGICAL ASSOCIATES, LLC
Practice address
500 Upper Chesapeake Dr
Bel Air, MD 21014-4324
Phone
(443) 643-1199
NPI assigned
Feb 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Authorized official

Name
Stephen Vincent Witman
Title
Cfo
Phone
(443) 643-3344

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X Primary

Addresses

Primary practice location

500 Upper Chesapeake Dr
Bel Air, MD 21014-4324

Mailing address

520 Upper Chesapeake Dr Ste 405
Bel Air, MD 21014-4381

Other practice location 1

501 S Union Ave
Havre DE Grace, MD 21078-3409
Phone (443) 643-1199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070309000291 MD Part B Supplier - Clinic/Group Practice 8729181805 Receives reassigned benefits from 36 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aberdeen, MD; Perryville, MD; Havre de Grace, MD; Elkton, MD; Bel Air, MD; Abingdon, MD

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3401 Box Hill Corporate Center Dr
Ste 100
Abingdon, MD 21009
Phone (410) 671-0017

510 Upper Chesapeake Dr
Ste 515
Bel Air, MD 21014
Phone (443) 643-3233

515 S Tollgate Rd
Ste 100
Bel Air, MD 21014
Phone (443) 643-3050

510 Upper Chesapeake Dr
Ste 308
Bel Air, MD 21014
Phone (443) 643-4438

2027 Pulaski Hwy
Ste 205
Havre de Grace, MD 21078
Phone (410) 652-7480

421 S Union Ave
Ste 202
Havre de Grace, MD 21078
Phone (443) 843-5800

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581379200000",
    "number": "1003448606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 UPPER CHESAPEAKE DR STE 405",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UPPER CHESAPEAKE DR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144324",
            "telephone_number": "443-643-1199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 S Union Ave",
            "address_purpose": "LOCATION",
            "city": "Havre DE Grace",
            "state": "MD",
            "postal_code": "210783409",
            "country_code": "US",
            "telephone_number": "443-643-1199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "UPPER CHESAPEAKE SURGICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "WITMAN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "443-643-3344"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.