Organization Active NPI

Summit Brachytherapy LLC

  • Ambulatory Surgical Clinic/Center
  • Baltimore, MD
National Provider Identifier
1306570940
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
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

Updated by the provider on Jun 25, 2025

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

Authorized official

Name
Sanford Siegel, MDNPI 1376506477
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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
O20230209001023 MD Part B Supplier - Ambulatory Surgical Center 0749652535 Practice locations: Baltimore, MD

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
21D2284635Summit Brachytherapy LLC3407 Wilkens Ave #200, Baltimore, MD 21229Certificate of waiverJun 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Summit Brachytherapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 1

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

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.

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

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.

Verify at the official NPI Registry.