Checkerspot Surgery Centers, LLC

Key facts

NPI: 1447685458
Entity type: Organization (NPI type 2)
Primary specialty: Ambulatory Surgical Clinic/Center 261QA1903X
Legal business name: CHECKERSPOT SURGERY CENTERS, LLC
Practice address: 1130 Annapolis Rd
Suite 102
Odenton, MD 21113-1648
Phone: (703) 347-1962
NPI assigned: Sep 10, 2013
Organization subpart: No

Authorized official

Name: Janak Vidyarthi, M.D.
Title: Medical Director
Phone: (703) 347-1962

Practitioners 2

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

Janak A Vidyarthi, M.D. Interventional Pain Medicine Physician · Odenton, MD · NPI 1619170685

Medicare reassignment NPD MD
Daniel Ezidiegwu Jr. Physical Medicine & Rehabilitation Physician · Odenton, MD · NPI 1184159444

Medicare reassignment NPD (past) MD

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
21D2075400	Checkerspot Surgery Centers LLC 1130 Annapolis Road Suite 102, Odenton, MD 21113	Certificate of waiver	Mar 26, 2028

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MD

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20140130000178	MD	Part B Supplier - Ambulatory Surgical Center	2860621539	Receives reassigned benefits from 2 practitioners Practice locations: Odenton, MD

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Ambulatory Surgical Clinic/Center	261QA1903X			Yes

Addresses

Primary practice location

1130 Annapolis Rd
Suite 102
Odenton, MD 21113-1648

Mailing address

1130 Annapolis Rd
Suite 102
Odenton, MD 21113-1648

Other providers in Odenton, MD

All providers in Odenton, MD · Ambulatory Surgical Clinic/Center in Maryland

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.