NPIMap

Organization Active NPI

Southern Maryland General Surgery LLC

  • Surgery Physician
  • Waldorf, MD
National Provider Identifier
1477098127
Registry record updated Jun 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
D0034140 Issued in MD
Legal business name
SOUTHERN MARYLAND GENERAL SURGERY LLC
Practice address
3261 Old Washington Rd
Suite 1012
Waldorf, MD 20602-3223
Phone
(301) 843-9060
Fax
(301) 645-3092
NPI assigned
Jan 4, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2017

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

Authorized official

Name
Dr. Abdel Aziz Basha El Said, M.D.NPI 1881606770
Title
Medical Doctor
Phone
(301) 843-9060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X D0034140 MD Primary

Addresses

Primary practice location

3261 Old Washington Rd
Suite 1012
Waldorf, MD 20602-3223

Mailing address

3261 Old Washington Rd
Suite 1012
Waldorf, MD 20602-3223
Phone (301) 843-9060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170223000868 MD Part B Supplier - Clinic/Group Practice 8426332271 Receives reassigned benefits from 1 practitioner
Practice locations: Waldorf, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498003200000",
    "number": "1477098127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3261 OLD WASHINGTON RD",
            "address_2": "SUITE 1012",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023223",
            "telephone_number": "301-843-9060",
            "fax_number": "301-645-3092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3261 OLD WASHINGTON RD",
            "address_2": "SUITE 1012",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023223",
            "telephone_number": "301-843-9060",
            "fax_number": "301-645-3092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MARYLAND GENERAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-04",
        "last_updated": "2017-06-21",
        "status": "A",
        "authorized_official_last_name": "EL SAID",
        "authorized_official_first_name": "ABDEL AZIZ",
        "authorized_official_middle_name": "BASHA",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "301-843-9060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MD",
            "license": "D0034140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.