NPIMap

Organization Active NPI

Complete Pain Surgery Center of White Marsh LLC

Doing business as Cpscwm

  • Ambulatory Surgical Clinic/Center
  • White Marsh, MD
National Provider Identifier
1063981801
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
COMPLETE PAIN SURGERY CENTER OF WHITE MARSH LLC
Doing business as
Cpscwm
Practice address
5430 Campbell Blvd Ste 111
White Marsh, MD 21162-5503
Phone
(410) 777-8971
Fax
(877) 595-7180
NPI assigned
Nov 23, 2018
Last updated
Feb 25, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Authorized official

Name
Ritu T Bhambhani, MDNPI 1053394130
Title
Owner
Phone
(410) 777-8971

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

5430 Campbell Blvd Ste 111
White Marsh, MD 21162-5503

Mailing address

100 Walter Ward Blvd Ste 200
Abingdon, MD 21009-1285
Phone (410) 777-8971

Other names 1

  • CPSCWM Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181217000662 MD Part B Supplier - Ambulatory Surgical Center 8527303718 Practice locations: White Marsh, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063981801. Details of each certification follow.

Ambulatory surgical center certification: CCN 21C0001622

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
COMPLETE PAIN SURGERY CENTER OF WHITE MARSH, LLC
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Nov 18, 2019
Last certification
Oct 29, 2019
Ownership / control type
Proprietary
Facility address
5430 Campbell Blvd, Suite 111
White Marsh, MD 21162

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1542931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582588800000",
    "number": "1063981801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WALTER WARD BLVD STE 200",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210091285",
            "telephone_number": "410-777-8971",
            "fax_number": "877-595-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 CAMPBELL BLVD STE 111",
            "city": "WHITE MARSH",
            "state": "MD",
            "postal_code": "211625503",
            "telephone_number": "410-777-8971",
            "fax_number": "877-595-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE PAIN SURGERY CENTER OF WHITE MARSH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-23",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A",
        "authorized_official_last_name": "BHAMBHANI",
        "authorized_official_first_name": "RITU",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-777-8971",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CPSCWM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in White Marsh, MD

Sources for this page

Verify at the official NPI Registry.