Active NPI
Um Shore Regional Health Surgery Center at Cambridge, LLC
- Ambulatory Surgical Clinic/Center
- Cambridge, MD
National Provider Identifier
1285213009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- UM SHORE REGIONAL HEALTH SURGERY CENTER AT CAMBRIDGE, LLC
- Practice address
- 713 Cambridge Marketplace Blvd
Ste 2-200
Cambridge, MD 21613 - Phone
- (410) 822-1000
- NPI assigned
- Apr 7, 2021
- 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
- Kenneth D Kozel
- Title
- President & Ceo
- Phone
- (410) 822-1000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
713 Cambridge Marketplace Blvd
Ste 2-200
Cambridge, MD 21613
Mailing address
219 S Washington St
Easton, MD 21601-2913
Phone (410) 822-1000
Other names 1
- UM SHORE REGIONAL HEALTH SURGERY CENTER AT CAMBRIDGE
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211019000774 | MD | Part B Supplier - Ambulatory Surgical Center | 2769870062 | Practice locations: Cambridge, MD |
National Provider Directory
National Provider DirectoryLocations
713 Cambridge Marketplace Blvd
#2200
Cambridge, MD 21613
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Um Shore Regional Health Surgery Center at Cambridge LLC
- Medicare certification status
- Active
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617753600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1627257600000",
"number": "1285213009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "219 S WASHINGTON ST",
"city": "EASTON",
"state": "MD",
"postal_code": "216012913",
"telephone_number": "410-822-1000",
"fax_number": "410-822-7834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "713 CAMBRIDGE MARKETPLACE BLVD",
"address_2": "STE 2-200",
"city": "CAMBRIDGE",
"state": "MD",
"postal_code": "21613",
"telephone_number": "410-822-1000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UM SHORE REGIONAL HEALTH SURGERY CENTER AT CAMBRIDGE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-04-07",
"last_updated": "2021-07-26",
"certification_date": "2021-06-29",
"status": "A",
"authorized_official_last_name": "KOZEL",
"authorized_official_first_name": "KENNETH",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "PRESIDENT & CEO",
"authorized_official_telephone_number": "410-822-1000"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "UM SHORE REGIONAL HEALTH SURGERY CENTER AT CAMBRIDGE",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "UM SHORE REGIONAL HEALTH SURGERY CENTER AT CAMBRIDGE",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Cambridge, MD
- Natalie Trice, CCC
- Alison Ruth Trise, OTR
- Lisa Marie Trissell, PHARMD
- Joyce W. Turner, LCSW-C
- Jeffrey Tyler, LCSW-C
- University of Maryland Community Medical Group, Inc.
- University of Maryland Community Medical Group, Inc.
- University of Maryland Community Medical Group, Inc.
- University of Maryland Community Medical Group, Inc.
- University of Maryland Community Medical Group, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.