Delmar Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

D0036586 Issued in MD

Legal business name

DELMAR SURGICAL CENTER LLC

Practice address

103 Chesapeake Blvd Ste C
Elkton, MD 21921-6313

Phone

(410) 392-6133

Fax

(410) 392-4958

NPI assigned

Nov 1, 2006

Last updated

Feb 6, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacqueline J Stack

Title

Director of Billing

Phone

(774) 320-3040

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Listed as

Delmar Surgical Center LLCCCN 21C0001277

Medicare certification status

ActiveFrom the Provider of Services file

Practitioners 1

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.

• Douglas Lavenburg, MD

  • Ophthalmology Physician
  • Elkton, MD
  • NPI 1649238635
  Medicare reassignment NPD

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1306924170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CHESAPEAKE BLVD STE C",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219216313",
            "telephone_number": "410-392-6133",
            "fax_number": "410-392-4958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 CHESAPEAKE BLVD STE C",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219216313",
            "telephone_number": "410-392-6133",
            "fax_number": "410-392-4958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELMAR SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A",
        "authorized_official_last_name": "STACK",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "774-320-3040"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "D0036586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "074Z",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan Decarlo, LMSW
• Claire Decker, PHARMD
• Delaware Cardiovascular Associates, P.a.
• Delaware Medicine & OBGYN LLC
• Delmar Emergency Specialists PA
• Delmarva Anesthesia, LLC
• Michele Y Delpier, MD
• Delta Wave Anesthesia, LLC
• Dental Professionals of Maryland, Charles Foer, PC (Dental Care of Elkton)
• Hannah Cristina Dequina, CRNP

• Ambulatory Surgical Clinic/Center in Elkton, MD
• Providers in Elkton, 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 Feb 6, 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.