Peninsula Endoscopy Center, LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Delmar, MD
NPI 1023162013 · NPPES record last updated Sep 10, 2008
Key facts
- NPI
- 1023162013
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- License
- 014352 (MD)
- Legal business name
- PENINSULA ENDOSCOPY CENTER, LLC
- Practice address
- 9315 Ocean Highway
Delmar, MD 21875-2339 - Phone
- (410) 896-9005
- Fax
- (410) 896-9337
- NPI assigned
- Jan 23, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Kota L Chandrasekhara, M.D.
- Title
- President
- Phone
- (410) 896-9005
Other NPIs on the same Medicare enrollment 5
Practitioners 19
-
Kota Chandrasekhara, M.D.
-
Zilla Huma Hussain, M.D.
-
Steven Turnamian, M.D.
-
Patricia T Bratek, CRNA
-
George N Galifianakis, M.D.
-
Marleen McKenzie, M.D.
-
Deborah Ann Qualey, M.D.
-
Mary Driscoll Schaeffer, CRNA
-
Dennis Forbes, M.D.
-
Nicholas C Gagliano, M.D.
-
Vivian L Griffin, MD
-
Rodrigo Herreros, M.D.
-
Michael S. Katz, M.D.
-
Frederick Gennaro Panico, M.D.
-
Cynthia C Presnell, CRNA
-
Roderick M Relova, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081031000296 | MD | Part B Supplier - Clinic/Group Practice | 3870669419 |
Receives reassigned benefits from 42 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Columbia, MD; Frederick, MD; Ijamsville, MD; Salisbury, MD |
National Provider Directory
Locations
9315 Ocean Hwy
#A
Delmar, MD 21875
Phone (410) 896-9005
2500 York Rd
Ste 200
Jamison, PA 18929
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | 014352 | MD | Yes |
Addresses
Primary practice location
9315 Ocean Highway
Delmar, MD 21875-2339
Mailing address
9315 Ocean Highway
Delmar, MD 21875-2339
Phone (410) 896-9005
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 409018700 | Medicaid | MD |
Other providers in Delmar, MD
- Carolyn G Kern
- Zoha Raheem Khan
- Kimberley Ann Houlihan LLC
- Alexis Vickers Layton
- Tammy Lynn Palacio
- Peninsula Gastroenterology Assn , P a
- Deborah Ann Qualey
- Billy R Rhodes
- Rite Aid of Maryland Inc
- Chisola Njapau Sherman
All providers in Delmar, MD · Ambulatory Surgical Clinic/Center in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.