NPIMap

Organization Active NPI

MSC Ambulatory Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Bethesda, MD
National Provider Identifier
1417118407
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
A1422R Issued in MD
Legal business name
MSC AMBULATORY SURGICAL CENTER, LLC
Practice address
6410 Rockledge Dr Ste 500
Bethesda, MD 20817-1843
Phone
(301) 581-0170
Fax
(301) 624-5837
NPI assigned
Jun 23, 2008
Last updated
Dec 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Corrie Powell
Title
Credentialing
Phone
(301) 695-8346

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X A1422R MD Primary

Addresses

Primary practice location

6410 Rockledge Dr Ste 500
Bethesda, MD 20817-1843

Mailing address

77 Thomas Johnson Dr
Suite E
Frederick, MD 21702-4893
Phone (301) 695-8346

Other practice location 1

77 Thomas Johnson Dr
Suite E
Frederick, MD 21702-4893
Phone (301) 695-8346

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081031000070 DC Part B Supplier - Ambulatory Surgical Center 6608878012 Receives reassigned benefits from 1 practitioner
Practice locations: Bethesda, MD

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
MSC Ambulatory Surgical Center LLCCCN 21C0001489
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
MSC Ambulatory Surgical Center2 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.

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1417118407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 THOMAS JOHNSON DR",
            "address_2": "SUITE E",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024893",
            "telephone_number": "301-695-8346",
            "fax_number": "301-668-7819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 ROCKLEDGE DR STE 500",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208171843",
            "telephone_number": "301-581-0170",
            "fax_number": "301-624-5837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Thomas Johnson Dr",
            "address_2": "Suite E",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024893",
            "country_code": "US",
            "telephone_number": "301-695-8346",
            "fax_number": "301-624-5837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MSC AMBULATORY SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-23",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "CORRIE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "301-695-8346"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "A1422R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.