Organization Active NPI

Ellicott City Ambulatory Surgery Center, LLLP

Doing business as Ellicott City Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Ellicott City, MD
National Provider Identifier
1114025608
Registry record updated Jun 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
A1003R Issued in MD
Legal business name
ELLICOTT CITY AMBULATORY SURGERY CENTER, LLLP
Doing business as
Ellicott City Ambulatory Surgery Center
Practice address
2850 North Ridge Road
Ellicott City, MD 21043
Phone
(410) 461-1600
Fax
(410) 750-7615
NPI assigned
Sep 20, 2006
Last updated
Jun 11, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2010

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

Authorized official

Name
Mrs. Maureen G Hartley, RN
Title
Administrator
Phone
(410) 461-1600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X A1003R MD Primary

Addresses

Primary practice location

2850 North Ridge Road
Ellicott City, MD 21043

Mailing address

2850 North Ridge Road
Ellicott City, MD 21043
Phone (410) 461-1600

Other identifiers 1

IdentifierTypeStateIssuer
410706300MedicaidMD

Other names 1

  • Ellicott City Ambulatory Surgery Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050520000032 MD Part B Supplier - Ambulatory Surgical Center 9537100458 Practice locations: Ellicott City, MD

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Ellicott City Ambulatory Surgery Center LLLPCCN 21C0001003
Medicare certification status
ActiveFrom the Provider of Services file

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276214400000",
    "number": "1114025608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 NORTH RIDGE ROAD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "21043",
            "telephone_number": "410-461-1600",
            "fax_number": "410-750-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 NORTH RIDGE ROAD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "21043",
            "telephone_number": "410-461-1600",
            "fax_number": "410-750-7615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLICOTT CITY AMBULATORY SURGERY CENTER, LLLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-06-11",
        "status": "A",
        "authorized_official_last_name": "HARTLEY",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "410-461-1600",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "A1003R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410706300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellicott City Ambulatory Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2010; 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.