NPIMap

Organization Active NPI

Martha Jefferson Hospital

Doing business as Martha Jefferson Outpatient Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Charlottesville, VA
National Provider Identifier
1225452303
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
MARTHA JEFFERSON HOSPITAL
Doing business as
Martha Jefferson Outpatient Surgery Center
Practice address
595 Martha Jefferson Dr
Suite 290
Charlottesville, VA 22911-4669
Phone
(434) 654-7000
NPI assigned
Feb 11, 2014
Organization subpart
Yes
Parent organization
MARTHA JEFFERSON HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Authorized official

Name
Melinda Summerlin Hancock
Title
Cfo
Phone
(757) 455-7458

Specialties & licenses 1

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

Addresses

Primary practice location

595 Martha Jefferson Dr
Suite 290
Charlottesville, VA 22911-4669

Mailing address

500 Martha Jefferson Dr
Charlottesville, VA 22911-4668

Other names 1

  • Martha Jefferson Outpatient Surgery Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140523001562 VA Part B Supplier - Ambulatory Surgical Center 1557279742 Practice locations: Charlottesville, VA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Sentara Martha Jefferson Outpatient Surgery CenterCCN 49C0001061
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
49D2078614Martha Jefferson Outpatient Surgery Center595 Martha Jefferson Drive - Suite 290, Charlottesville, VA 22911Certificate of waiverJun 1, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
The Something Special Shop595 Martha Jefferson Dr, Charlottesville, VA 22911-4669(434) 654-5454 Breast Prostheses and/or Accessories Accepts assignmentParticipating since Oct 1, 1984

National Provider Directory

National Provider Directory
Tax ID family
Martha Jefferson Med SV7 organizations share this tax ID, including this one
Part of
Martha Jefferson Med SV

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

590 Peter Jefferson Pkwy
Ste 300
Charlottesville, VA 22911
Phone (434) 654-7794

595 Martha Jefferson Dr
#29
Charlottesvle, VA 22911
Phone (434) 654-5256

NPI Registry JSON

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

{
    "created_epoch": "1392076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1225452303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MARTHA JEFFERSON DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 MARTHA JEFFERSON DR",
            "address_2": "SUITE 290",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114669",
            "telephone_number": "434-654-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTHA JEFFERSON HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARTHA JEFFERSON HOSPITAL",
        "enumeration_date": "2014-02-11",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A",
        "authorized_official_last_name": "HANCOCK",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "SUMMERLIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "757-455-7458"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Martha Jefferson Outpatient Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; 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.