NPIMap

Organization Active NPI

Zion Ambulatory Center LLC

  • Ambulatory Surgical Clinic/Center
  • Baltimore, MD
National Provider Identifier
1023055001
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ZION AMBULATORY CENTER LLC
Practice address
9106 Philadelphia Rd Ste 108
Baltimore, MD 21237-4335
Phone
(410) 682-5040
Fax
(410) 682-5044
NPI assigned
May 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Authorized official

Name
Dr. Michael A. Gardyn, D.O.NPI 1205981867
Title
President
Phone
(410) 499-0082

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

9106 Philadelphia Rd Ste 108
Baltimore, MD 21237-4335

Mailing address

9106 Philadelphia Rd Ste 108
Baltimore, MD 21237-4335
Phone (410) 682-5040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060118000673 MD Part B Supplier - Ambulatory Surgical Center 8729002613 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD

Ambulatory surgical center certification: CCN 21C0001426

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ZION AMBULATORY CENTER, LLC
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Dec 5, 2005
Last certification
Sep 20, 2019
Ownership / control type
Proprietary
Facility address
9106 Philadelphia Rd, Suite 108
Baltimore, MD 21237

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652400000000",
    "number": "1023055001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9106 PHILADELPHIA RD STE 108",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212374335",
            "telephone_number": "410-682-5040",
            "fax_number": "410-682-5044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9106 PHILADELPHIA RD STE 108",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212374335",
            "telephone_number": "410-682-5040",
            "fax_number": "410-682-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZION AMBULATORY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A",
        "authorized_official_last_name": "GARDYN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-499-0082",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.