NPIMap

Organization Active NPI

Horizon Surgical Group, PA

  • Vascular Surgery Physician
  • Germantown, MD
National Provider Identifier
1366449365
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
HORIZON SURGICAL GROUP, PA
Practice address
20410 Observation Drive
Suite 100
Germantown, MD 20876-6419
Phone
(301) 762-0277
Fax
(301) 330-9108
NPI assigned
Jul 5, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Authorized official

Name
Mr. Robert Fox, M.D.
Title
Partner/Authorized Official
Phone
(301) 330-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X MD Primary

Addresses

Primary practice location

20410 Observation Drive
Suite 100
Germantown, MD 20876-6419

Mailing address

20410 Observation Drive
Suite 100
Germantown, MD 20876-6419
Phone (301) 762-0277

Other identifiers 1

IdentifierTypeStateIssuer
915011100MedicaidMD

Other names 1

  • Horizon Vascular Specialists Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040209000688 DC Part B Supplier - Clinic/Group Practice 3173417540 Receives reassigned benefits from 9 practitioners
Practice locations: Germantown, MD; Olney, MD; Rockville, MD
O20061229000039 MD Part B Supplier - Clinic/Group Practice 3173417540 Receives reassigned benefits from 11 practitioners
Practice locations: Frederick, MD

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

915 Toll House Ave
Ste 101
Frederick, MD 21701
Phone (301) 330-1000

18111 Prince Philip Dr
Ste 226
Olney, MD 20832
Phone (301) 762-0277

9715 Medical Center Dr
Ste 105
Rockville, MD 20850
Phone (301) 762-0277

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490140800000",
    "number": "1366449365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20410 OBSERVATION DRIVE",
            "address_2": "SUITE 100",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208766419",
            "telephone_number": "301-762-0277",
            "fax_number": "301-330-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20410 OBSERVATION DRIVE",
            "address_2": "SUITE 100",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208766419",
            "telephone_number": "301-762-0277",
            "fax_number": "301-330-9108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HORIZON SURGICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-05",
        "last_updated": "2017-03-22",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PARTNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "301-330-1000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "915011100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Horizon Vascular Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Germantown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.