Active NPI
Summit Brachytherapy LLC
- Ambulatory Surgical Clinic/Center
- Baltimore, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- SUMMIT BRACHYTHERAPY LLC
- Practice address
- 3407 Wilkens Ave Ste 200
Baltimore, MD 21229-5221 - Phone
- (410) 644-0929
- NPI assigned
- Jul 11, 2022
- 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
- Sanford Siegel, MD
- Title
- Ao
- Phone
- (410) 581-1600
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
3407 Wilkens Ave Ste 200
Baltimore, MD 21229-5221
Mailing address
10200 Grand Central Ave Ste 220
Owings Mills, MD 21117-4366
Phone (559) 385-3817
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230209001023 | MD | Part B Supplier - Ambulatory Surgical Center | 0749652535 | Practice locations: Baltimore, MD |
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 |
|---|---|---|---|
| 21D2284635 | Summit Brachytherapy LLC | Certificate of waiver | Jun 26, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Summit Brachytherapy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Ambulatory Surgical Clinic/Center
- Germantown, MD
- NPI 1679207211
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Towson, MD
- NPI 1235334335
Member Of
Locations
3407 Wilkens Ave
Ste 200
Baltimore, MD 21229
Phone (410) 644-0929
21 Crossroads Dr
Ste 220
Owings Mills, MD 21117
Phone (443) 738-8130
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Urology Physician
- Owings Mills, MD
- NPI 1376506477
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657497600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1750809600000",
"number": "1306570940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10200 GRAND CENTRAL AVE STE 220",
"city": "OWINGS MILLS",
"state": "MD",
"postal_code": "211174366",
"telephone_number": "559-385-3817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3407 WILKENS AVE STE 200",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212295221",
"telephone_number": "410-644-0929"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUMMIT BRACHYTHERAPY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-07-11",
"last_updated": "2025-06-25",
"certification_date": "2025-06-25",
"status": "A",
"authorized_official_last_name": "SIEGEL",
"authorized_official_first_name": "SANFORD",
"authorized_official_title_or_position": "AO",
"authorized_official_telephone_number": "410-581-1600",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
- Summit Ambulatory Surgical Center, LLC
- Summit Ambulatory Surgical Center, LLC
- Summit Ambulatory Surgical Center, LLC
- Summit Ambulatory Surgical Center, LLC
- Summit Ambulatory Surgical Center, LLC
- Summit Community Health, Inc
- Summit Community Health, Inc
- Summit Community Health, Inc
- Summit Community Health, Inc
- Summit Community Health, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.