Summit Ambulatory Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SUMMIT AMBULATORY SURGICAL CENTER LLC

Practice address

251 Lewis Lane
Suite 203
Havre de Grace, MD 21078-5421

Phone

(410) 942-0130

Fax

(410) 939-3538

NPI assigned

Aug 20, 2008

Last updated

Jul 28, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sanford J. Siegel, M.D.

Title

President/Chief Executive Officer

Phone

(443) 738-8163

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477700516. Details of each certification follow.

• CCN 21C0001493 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 21C0001493

Legal name

SUMMIT AMBULATORY SURGERY CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jul 29, 2009

Last certification

Jul 15, 2019

Ownership / control type

Proprietary

Facility address

251 Lewis Lane, Suite 203
Havre de Grace, MD 21078

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Summit Ambulatory Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Columbia, MD
  • NPI 1912434697

  O20090218000404

  Same enrollment

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

• Chesapeake Urology Associates, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Beltsville, MD
  • NPI 1619792744

  Member Of

  NPD member
• Baylor University Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Dallas, TX
  • NPI 1518967231

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  dba Baptist Health System

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469664000000",
    "number": "1477700516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CROSSROADS DRIVE",
            "address_2": "SUITE 306",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174295",
            "telephone_number": "443-738-2872",
            "fax_number": "443-738-2713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 LEWIS LANE",
            "address_2": "SUITE 203",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210785421",
            "telephone_number": "410-942-0130",
            "fax_number": "410-939-3538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT AMBULATORY SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-20",
        "last_updated": "2016-07-28",
        "status": "A",
        "authorized_official_last_name": "SIEGEL",
        "authorized_official_first_name": "SANFORD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT/CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "443-738-8163",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800906615",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel David Staskel, LPTA
• Janna Steinberg
• Lori Stephen, LCSW-C
• Lauren Knott Stephens, OD
• Steven C. Marks, MD, PA
• Summit Chiropractic P.a.
• Summit Pain Management Group,Inc
• Susquehanna Counseling Services LLC
• Susquehanna Health and Wellness
• Susquehanna OB-GYN LLC

• Ambulatory Surgical Clinic/Center in Havre de Grace, MD
• Providers in Havre de Grace, MD by specialty
• Ambulatory Surgical Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.