Clearway Surgery Center of Elkton, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CLEARWAY SURGERY CENTER OF ELKTON, LLC

Practice address

101 Chesapeake Blvd Ste C-2
Elkton, MD 21921-6607

Phone

(855) 527-7246

Fax

(866) 229-5063

NPI assigned

May 18, 2022

Organization subpart

No

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

Authorized official

Name

Ira Kornbluth, M.D.

Title

President

Phone

(855) 527-7246

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Listed as

Clearway Surgery Center of Elkton LLCCCN 21C0001661

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652832000000",
    "number": "1104563444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 DEFENSE HWY STE 205",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017096",
            "telephone_number": "855-527-7246",
            "fax_number": "866-229-5063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CHESAPEAKE BLVD STE C-2",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219216607",
            "telephone_number": "855-527-7246",
            "fax_number": "866-229-5063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWAY SURGERY CENTER OF ELKTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-18",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A",
        "authorized_official_last_name": "KORNBLUTH",
        "authorized_official_first_name": "IRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "855-527-7246",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher W. Koterwas, D.D.S.,P.a.
• Jason Chrystal, LMSW
• Stacy Jo Ciano, LCSW-C
• City Pharmacy of Elkton, Inc.
• Clearway Anesthesia Services NE LLC
• Rebecca Anne Cleiman, D.D.S.
• William Michael Clifford, DC
• Nancy Clough, RN
• Rachel Christine Coats
• Michael Coffey, LCPC

• Ambulatory Surgical Clinic/Center in Elkton, MD
• Providers in Elkton, MD by specialty
• Ambulatory Surgical Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; 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.