NPIMap

Organization Active NPI

Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

Doing business as Tysons Corner Medical Center Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • McLean, VA
National Provider Identifier
1073678637
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
Doing business as
Tysons Corner Medical Center Ambulatory Surgery Center
Practice address
8008 Westpark Dr
MC Lean, VA 22102-3109
Phone
(703) 490-8400
NPI assigned
Dec 26, 2006
Last updated
Jul 24, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Authorized official

Name
Colleen Swinton
Title
Director, Credentialing
Phone
(301) 257-2797

Specialties & licenses 1

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

Addresses

Primary practice location

8008 Westpark Dr
MC Lean, VA 22102-3109

Mailing address

4000 Garden City Dr
Hyattsville, MD 20785-2418
Phone (301) 816-2424

Other names 1

  • Tysons Corner Medical Center Ambulatory Surgery Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100729000796 DC Part B Supplier - Ambulatory Surgical Center 3779495858 Receives reassigned benefits from 749 practitioners
Practice locations: McLean, VA

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 16

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Kaiser Foundation Health Plan of the Mid Atlantic StatCCN 49C0001017
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Part of
Kaiser Georgetown Comm

Practitioners & affiliated clinicians

Practitioners 755

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.

View all 755

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1073678637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 GARDEN CITY DR",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207852418",
            "telephone_number": "301-816-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8008 WESTPARK DR",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023109",
            "telephone_number": "703-490-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC",
        "enumeration_date": "2006-12-26",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A",
        "authorized_official_last_name": "SWINTON",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "DIRECTOR, CREDENTIALING",
        "authorized_official_telephone_number": "301-257-2797"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6104 Old Branch Ave",
            "city": "Temple Hills",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207482518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Tysons Corner Medical Center Ambulatory Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tysons Corner Medical Center Ambulatory Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McLean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.