DC Metropolitan Vascular & Ir Procedure Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

DC METROPOLITAN VASCULAR & IR PROCEDURE CENTER LLC

Practice address

5801 Allentown Rd Ste 502
Camp Springs, MD 20746-4653

Phone

(240) 427-1630

Fax

(240) 492-2070

NPI assigned

Feb 26, 2025

Last updated

Feb 26, 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

Michael Licatta

Title

President

Phone

(240) 427-1630

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1740528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1386441491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 ALLENTOWN RD STE 502",
            "city": "CAMP SPRINGS",
            "state": "MD",
            "postal_code": "207464653",
            "telephone_number": "240-427-1630",
            "fax_number": "240-492-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 ALLENTOWN RD STE 502",
            "city": "CAMP SPRINGS",
            "state": "MD",
            "postal_code": "207464653",
            "telephone_number": "240-427-1630",
            "fax_number": "240-492-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DC METROPOLITAN VASCULAR & IR PROCEDURE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-26",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A",
        "authorized_official_last_name": "LICATTA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-427-1630"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Camp Springs, MD
• Providers in Camp Springs, 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 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.