Active NPI
Advanced Eye Laser and Surgery Center
- Ambulatory Surgical Clinic/Center
- Sparks, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- 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, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sudeep Pramanik, MD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D2328540 | Advanced Eye Laser and Surgery Center | Certificate of waiver | Aug 11, 2027 |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Ophthalmology Physician
- Towson, MD
- NPI 1225020159
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; 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.
- 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.