Active NPI
Surgicenter of Baltimore
- Ambulatory Surgical Clinic/Center
- Owings Mills, MD
National Provider Identifier
1447254172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- License
- A1045
- Legal business name
- SURGICENTER OF BALTIMORE
- Practice address
- 23 Crossroads Drive
Ste 100
Owings Mills, MD 21117-5420 - Phone
- (410) 356-0300
- Fax
- (410) 356-7507
- NPI assigned
- Jun 10, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stephanie Mattes
- Title
- Billing Coordinator
- Phone
- (410) 356-0300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | A1045 | MD | Primary |
Addresses
Primary practice location
23 Crossroads Drive
Ste 100
Owings Mills, MD 21117-5420
Mailing address
23 Crossroads Drive
Ste 100
Owings Mills, MD 21117-5420
Phone (410) 356-0300
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 055335 | Other | MD | JOHNS HOPKINS |
| 0181741 | Other | MD | AETNA |
| 110694 | Other | MD | KAISER |
| 242321900 | Medicaid | MD | |
| 20103019SA | Other | MD | CIGNA |
| 02LM | Other | MD | BCBS |
| NE3 | Other | MD | CAREFIRST BCBS |
| 25872 | Other | MD | MAMSI |
| 6800095 | Other | MD | UNITED HEALTHCARE |
| 2614116 | Other | MD | AETNA |
| 490001255 | Other | MD | MEDICARE RAILROAD |
Other names 1
- SurgiCenter of Baltimore
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040323000273 | MD | Part B Supplier - Ambulatory Surgical Center | 2769380393 | Practice locations: Owings Mills, MD |
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Surgicenter of Baltimore LLC
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Baptist Health System
- Psychiatric Hospital Unit
- San Antonio, TX
- NPI 1487633509
Member Of
Locations
23 Crossroads Dr
Owings Mills, MD 21117
Phone (410) 356-0300
Practitioners & affiliated clinicians
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.
-
- Otolaryngology Physician
- Owings Mills, MD
- NPI 1558520775
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118361600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1734566400000",
"number": "1447254172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 CROSSROADS DRIVE",
"address_2": "STE 100",
"city": "OWINGS MILLS",
"state": "MD",
"postal_code": "211175420",
"telephone_number": "410-356-0300",
"fax_number": "410-356-7507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 CROSSROADS DRIVE",
"address_2": "STE 100",
"city": "OWINGS MILLS",
"state": "MD",
"postal_code": "211175420",
"telephone_number": "410-356-0300",
"fax_number": "410-356-7507"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SURGICENTER OF BALTIMORE",
"organizational_subpart": "NO",
"enumeration_date": "2005-06-10",
"last_updated": "2024-12-19",
"certification_date": "2024-12-19",
"status": "A",
"authorized_official_last_name": "MATTES",
"authorized_official_first_name": "STEPHANIE",
"authorized_official_title_or_position": "BILLING COORDINATOR",
"authorized_official_telephone_number": "410-356-0300"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "MD",
"license": "A1045",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHNS HOPKINS",
"identifier": "055335",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0181741",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER",
"identifier": "110694",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "242321900",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "20103019SA",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "02LM",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BCBS",
"identifier": "NE3",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "25872",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "6800095",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2614116",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "490001255",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "SurgiCenter of Baltimore",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Owings Mills, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.