NPIMap

Organization Active NPI

Eye Surgery Center of White Marsh, LLC

  • Ophthalmologic Surgery Clinic/Center
  • Baltimore, MD
National Provider Identifier
1336288224
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X
License
A1374 Issued in MD
Legal business name
EYE SURGERY CENTER OF WHITE MARSH, LLC
Practice address
9512 Harford Rd
Suite 5
Baltimore, MD 21234-3120
Phone
(410) 663-4466
Fax
(410) 663-4556
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert Kasper, MD
Title
Medical Director
Phone
(410) 663-4466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmologic Surgery Clinic/Center 261QS0132X A1374 MD Primary

Addresses

Primary practice location

9512 Harford Rd
Suite 5
Baltimore, MD 21234-3120

Mailing address

9512 Harford Rd
Suite 5
Baltimore, MD 21234-3120
Phone (410) 663-4466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120402000538 MD Part B Supplier - Ambulatory Surgical Center 1355518101 Practice locations: Baltimore, MD

Ambulatory surgical center certification: CCN 21C0001374

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
EYE SURGERY CENTER OF WHITE MARSH, LLC
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Feb 24, 2003
Last certification
Mar 5, 2019
Ownership / control type
Proprietary
Facility address
9512 Harford Road, Suite 5- 6
Baltimore, MD 21234

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
21D1098278Eye Surgery Center of White Marsh9512 Harford Road Suite 5, Baltimore, MD 21234Certificate of waiverApr 14, 2027

National Provider Directory

National Provider Directory

Member of 1

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

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": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336288224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9512 HARFORD RD",
            "address_2": "SUITE 5",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212343120",
            "telephone_number": "410-663-4466",
            "fax_number": "410-663-4556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9512 HARFORD RD",
            "address_2": "SUITE 5",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212343120",
            "telephone_number": "410-663-4466",
            "fax_number": "410-663-4556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SURGERY CENTER OF WHITE MARSH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KASPER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "410-663-4466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "MD",
            "license": "A1374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.