Organization Active NPI

Advanced Eye Laser and Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Sparks, MD
National Provider Identifier
1174329502
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ADVANCED EYE LASER AND SURGERY CENTER
Practice address
954 Ridgebrook Rd Ste 300
Sparks, MD 21152-9440
Phone
(410) 618-5640
Fax
(410) 846-6905
NPI assigned
Feb 25, 2025
Last updated
May 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Authorized official

Name
Sudeep Pramanik, MDNPI 1225020159
Title
President
Phone
(717) 599-2747

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary
Ophthalmologic Surgery Clinic/Center 261QS0132X

Addresses

Primary practice location

954 Ridgebrook Rd Ste 300
Sparks, MD 21152-9440

Mailing address

1600 6TH Ave Ste 119B
York, PA 17403-2627
Phone (717) 650-6148

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250709002299 MD Part B Supplier - Ambulatory Surgical Center 1759895998 Practice locations: Sparks, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174329502. Details of each certification follow.

Ambulatory surgical center certification: CCN 21C0001698

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Advanced Eye Laser and Surgery Center, LLC
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Dec 22, 2025
Last certification
Dec 19, 2025
Facility address
954 Ridgebrook Rd. Suite 300
Sparks Glencoe, MD 21152

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
21D2328540Advanced Eye Laser and Surgery Center954 Ridgebrook Rd Ste 300, Sparks Glencoe, MD 21152Certificate of waiverAug 11, 2027

National Provider Directory

National Provider Directory

Locations

954 Ridgebrook Rd
Ste 300
Sparks Glencoe, MD 21152
Phone (410) 618-5640

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": "1740441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779321600000",
    "number": "1174329502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 6TH AVE STE 119B",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174032627",
            "telephone_number": "717-650-6148",
            "fax_number": "443-927-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 RIDGEBROOK RD STE 300",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529440",
            "telephone_number": "410-618-5640",
            "fax_number": "410-846-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED EYE LASER AND SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-25",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A",
        "authorized_official_last_name": "PRAMANIK",
        "authorized_official_first_name": "SUDEEP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-599-2747",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, MD

Sources for this page

Verify at the official NPI Registry.