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Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

Organization Active NPI Ambulatory Surgical Clinic/Center · Timonium, MD

NPI 1457023616 · NPPES record last updated Jul 24, 2025

Key facts

NPI
1457023616
Entity type
Organization (NPI type 2)
Primary specialty
Ambulatory Surgical Clinic/Center 261QA1903X
Legal business name
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
Practice address
2391 Greenspring Drive
Timonium, MD 21093
Phone
(301) 816-2424
NPI assigned
Oct 5, 2021
Organization subpart
Yes
Parent organization (as reported)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC

Authorized official

Name
Mrs. Colleen E Swinton
Title
Credentialing Director
Phone
(301) 257-2797

Other NPIs with the same Medicare PAC ID 16

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

Practitioners 2,005

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

View all 2,005

Medicare Care Compare: Ambulatory surgical center

Listed as
Kaiser Foundation Mid Atlantic States Dba Kaiser Permanente Lutherville Timonium ASC CCN 21C0001656
Medicare certification status
Active (Provider of Services file)

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MD

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220105001262 MD Part B Supplier - Ambulatory Surgical Center 3779495858 Receives reassigned benefits from 432 practitioners
Practice locations: Timonium, MD

National Provider Directory

Part of
Kaiser Found HLTH Plan

Locations

2101 E Jefferson St
Ste 4EPFS
Rockville, MD 20852

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Yes

Addresses

Primary practice location

2391 Greenspring Drive
Timonium, MD 21093

Mailing address

4000 Garden City Dr
Hyattsville, MD 20785-2418
Phone (301) 816-2424

Other names

  • Kaiser Permanente Lutherville-Timonium Ambulatory Surgery Center Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Other providers in Timonium, MD

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

Sources for this page

Verify at the official NPI Registry.