Organization Active NPI

Smart Pain Surgery Center at White Marsh

  • Ambulatory Surgical Clinic/Center
  • Nottingham, MD
National Provider Identifier
1164877684
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SMART PAIN SURGERY CENTER AT WHITE MARSH
Doing business as
Clearway Surgery Center of White Marsh
Practice address
8100 Sandpiper Cir
Suite 210
Nottingham, MD 21236-4991
Phone
(443) 693-7246
Fax
(410) 870-6026
NPI assigned
May 3, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Authorized official

Name
Ira Kornbluth, M.D.NPI 1609872266
Title
President
Phone
(855) 527-7246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

8100 Sandpiper Cir
Suite 210
Nottingham, MD 21236-4991

Mailing address

201 Defense Hwy Ste 205
Annapolis, MD 21401-7096
Phone (855) 527-7246

Other names 1

  • Clearway Surgery Center of White Marsh Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170227000799 MD Part B Supplier - Ambulatory Surgical Center 3375827942 Practice locations: Nottingham, MD

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Smart Pain Surgery Center at White MarshCCN 21C0001588
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2115934Clearway Surgery Center of White Marsh8100 Sandpiper Circle Ste 210, Nottingham, MD 21236Certificate of waiverJul 14, 2028

National Provider Directory

National Provider Directory

Locations

8100 Sandpiper Cir
Ste 21
Nottingham, MD 21236

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718755200000",
    "number": "1164877684",
    "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": "8100 SANDPIPER CIR",
            "address_2": "SUITE 210",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364991",
            "telephone_number": "443-693-7246",
            "fax_number": "410-870-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMART PAIN SURGERY CENTER AT WHITE MARSH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-03",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "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": [
        {
            "organization_name": "Clearway Surgery Center of White Marsh",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nottingham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.