Organization Active NPI

Children's Surgical Associates, LLC

  • Pediatric Surgery Physician
  • Baltimore, MD
National Provider Identifier
1073775359
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
Legal business name
CHILDREN'S SURGICAL ASSOCIATES, LLC
Practice address
6565 N Charles St
Ste 305
Baltimore, MD 21204-6800
Phone
(443) 849-6201
NPI assigned
Jun 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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

Authorized official

Name
James Buck, M.D.
Title
Owner
Phone
(443) 849-6201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0120X Primary

Addresses

Primary practice location

6565 N Charles St
Ste 305
Baltimore, MD 21204-6800

Mailing address

10085 Red Run Blvd
Ste 200
Owings Mills, MD 21117-4836
Phone (443) 204-8249

Other identifiers 3

IdentifierTypeStateIssuer
LN89CHOtherMDCAREFIRST OF MARYLAND
T409OtherMDCAREFIRST REGIONAL
805702800MedicaidMD

National Provider Directory

National Provider Directory

Locations

1212 York Rd
Ste B
Lutherville, MD 21093

10085 Red Run Blvd
Ste 200
Owings Mills, MD 21117

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1073775359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10085 RED RUN BLVD",
            "address_2": "STE 200",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174836",
            "telephone_number": "443-204-8249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 N CHARLES ST",
            "address_2": "STE 305",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046800",
            "telephone_number": "443-849-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S SURGICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-27",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "BUCK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-849-6201",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Pediatric Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST OF MARYLAND",
            "identifier": "LN89CH",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST REGIONAL",
            "identifier": "T409",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805702800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.