Four Corners Ambulatory Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

A1093 Issued in MD

Legal business name

FOUR CORNERS AMBULATORY SURGICAL CENTER LLC

Practice address

10101 Lorain Ave
Silver Spring, MD 20901-2458

Phone

(301) 681-8400

Fax

(301) 681-3339

NPI assigned

Jul 15, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Gary A Lieberman, D.P.M.NPI 1336338094

Title

Medical Director

Phone

(301) 681-8400

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Listed as

Four Corners Ambulatory Surgical Center LLCCCN 21C0001093

Medicare certification status

ActiveFrom the Provider of Services file

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Dr. Gary a. Lieberman, P.a.

  • Podiatrist
  • Silver Spring, MD
  • NPI 1023017654

  Member Of

  NPD member

Locations

Practitioners 2

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.

• Holly Beck, DPM

  • Podiatrist
  • Silver Spring, MD
  • NPI 1912938481

  DC

  Medicare reassignment NPD
• Gary A Lieberman, D.P.M.

  • Podiatrist
  • Silver Spring, MD
  • NPI 1336338094
  NPD (past) Authorized official

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412640000000",
    "number": "1285633818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 LORAIN AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209012458",
            "telephone_number": "301-681-8400",
            "fax_number": "301-681-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 LORAIN AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209012458",
            "telephone_number": "301-681-8400",
            "fax_number": "301-681-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR CORNERS AMBULATORY SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-15",
        "last_updated": "2014-10-07",
        "status": "A",
        "authorized_official_last_name": "LIEBERMAN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "301-681-8400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "A1093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Agnes Fouda Endale Epse Dzumafo
• Ivarys Fouegap Fonkeng
• Ghislaine Fougy, MD
• James Michael Foulkes, LMT
• Foundational Medicine LLC
• Kathryn Beaulieu Fournier, CPNP-PC
• Penelope Jayne Fovall, M.AC., L.AC.
• Ashley Fowler
• Bruce Todd Fox, DPM
• Evelyn Fox, CRNP

• Ambulatory Surgical Clinic/Center in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Ambulatory Surgical Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.