Organization Active NPI

Ambulatory Plastic Surgery Center Associates, Chartered

  • Plastic Surgery Physician
  • Rockville, MD
National Provider Identifier
1093908923
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
AMBULATORY PLASTIC SURGERY CENTER ASSOCIATES, CHARTERED
Practice address
15245 Shady Grove Rd
Suite 155
Rockville, MD 20850-3222
Phone
(240) 912-4708
Fax
(240) 912-6992
NPI assigned
Aug 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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

Authorized official

Name
Michael Paul Vincent, M.D.
Title
President
Phone
(240) 912-4708

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X MD Primary

Addresses

Primary practice location

15245 Shady Grove Rd
Suite 155
Rockville, MD 20850-3222

Mailing address

15245 Shady Grove Rd
Suite 155
Rockville, MD 20850-3222
Phone (240) 912-4708

Other identifiers 1

IdentifierTypeStateIssuer
G01044OtherMEDICARE GROUP NUMBER

National Provider Directory

National Provider Directory

Locations

15245 Shady Grove Rd
Ste 155
Rockville, MD 20850
Phone (240) 912-4708

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553472000000",
    "number": "1093908923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15245 SHADY GROVE RD",
            "address_2": "SUITE 155",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503222",
            "telephone_number": "240-912-4708",
            "fax_number": "240-912-6992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15245 SHADY GROVE RD",
            "address_2": "SUITE 155",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503222",
            "telephone_number": "240-912-4708",
            "fax_number": "240-912-6992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBULATORY PLASTIC SURGERY CENTER ASSOCIATES, CHARTERED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-23",
        "last_updated": "2019-03-25",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-912-4708",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "G01044",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.