Summit Ambulatory Surgical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SUMMIT AMBULATORY SURGICAL CENTER, LLC

Practice address

7625 Maple Lawn Blvd
Suite 205
Fulton, MD 20759-2565

Phone

(443) 738-2872

NPI assigned

Jan 16, 2009

Last updated

Aug 26, 2011By 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

Sanford J. Siegel, MD

Title

President

Phone

(443) 738-2872

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144467804. Details of each certification follow.

• CCN 21C0001495 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 21C0001495

Legal name

SUMMIT AMBULATORY SURGICAL CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Nov 24, 2009

Last certification

Nov 15, 2019

Ownership / control type

Proprietary

Facility address

7625 Maple Lawn Blvd Suite 205
Fulton, MD 20759

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Chesapeake Urology Associates, P a

  • Durable Medical Equipment & Medical Supplies
  • Owings Mills, MD
  • NPI 1477759124

  Member Of

  NPD member

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314316800000",
    "number": "1144467804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CROSSROADS DR",
            "address_2": "SUITE 306",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175421",
            "telephone_number": "443-738-2872",
            "fax_number": "443-738-2713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7625 MAPLE LAWN BLVD",
            "address_2": "SUITE 205",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592565",
            "telephone_number": "443-738-2872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT AMBULATORY SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-16",
        "last_updated": "2011-08-26",
        "status": "A",
        "authorized_official_last_name": "SIEGEL",
        "authorized_official_first_name": "SANFORD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "443-738-2872",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Fulton, MD
• Providers in Fulton, 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 Aug 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.