Lutherville Surgicenter, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

A1302 Issued in MD

Legal business name

LUTHERVILLE SURGICENTER, LLC

Practice address

1400 Front Ave
Suite 100a
Lutherville, MD 21093-5300

Phone

(410) 828-1525

Fax

(410) 828-5045

NPI assigned

Jul 4, 2006

Last updated

Mar 16, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Russell Moore, M.D.NPI 1487688347

Title

Medical Director

Phone

(410) 296-6232

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Listed as

Lutherville Surgicenter LLCCCN 21C0001302

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

Practitioners 2

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.

• John Russell Moore, M.D.

  • Orthopaedic Hand Surgery Physician
  • Lutherville, MD
  • NPI 1487688347
  Authorized official Same address or phone
• Keith A. Segalman, M.D.

  • Orthopaedic Hand Surgery Physician
  • Lutherville, MD
  • NPI 1407810336
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205625600000",
    "number": "1124058946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 FRONT AVE",
            "address_2": "SUITE 100A",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210935300",
            "telephone_number": "410-828-1525",
            "fax_number": "410-828-5045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 FRONT AVE",
            "address_2": "SUITE 100A",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210935300",
            "telephone_number": "410-828-1525",
            "fax_number": "410-828-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERVILLE SURGICENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2008-03-16",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "410-296-6232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "A1302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisabeth Karen Lucas, M.D.
• Julie A Luterzo, NP
• Lutherville Endoscopy Center LLC
• Lutherville Hematology and Oncology Services
• Lutherville Hematology and Oncology Services
• Lux Medica LLC
• Carly Maass, SLP
• Phillip F Mac, MD
• Cathryne Lynn Maciolek Waugh, PSY. D
• Sandra Mackenzie

• Ambulatory Surgical Clinic/Center in Lutherville, MD
• Providers in Lutherville, 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 Mar 16, 2008; 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.