Phoenix Surgical Care LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

PHOENIX SURGICAL CARE LLC

Doing business as

Phoenix Surgical Care

Practice address

174 Thomas Johnson Dr Ste 100
Frederick, MD 21702-4569

Phone

(301) 662-2000

Fax

(301) 662-2500

NPI assigned

Mar 19, 2020

Organization subpart

No

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

Authorized official

Name

Jasmine Malcolm, MDNPI 1750520888

Title

Owner

Phone

(301) 662-2000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Phoenix Surgical Care Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 1

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

• Jasmine Malcolm, MD

  • Surgery Physician
  • Frederick, MD
  • NPI 1750520888
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657584000000",
    "number": "1518593797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 THOMAS JOHNSON DR STE 100",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024569",
            "telephone_number": "301-662-2000",
            "fax_number": "301-662-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 THOMAS JOHNSON DR STE 100",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024569",
            "telephone_number": "301-662-2000",
            "fax_number": "301-662-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "197 Thomas Johnson Dr",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024314",
            "country_code": "US",
            "telephone_number": "301-662-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "77 Thomas Johnson Dr Ste K",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024893",
            "country_code": "US",
            "telephone_number": "301-662-2000",
            "fax_number": "301-662-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHOENIX SURGICAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-19",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A",
        "authorized_official_last_name": "MALCOLM",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-662-2000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MARYLAND (DEPARTMENT OF HEALTH)",
            "identifier": "D0073819",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Surgical Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sydni Phelps, SLP
• Philip J McGann MD,PA
• Hamblin Phillips
• Todd Phillips
• Phoenix Mental Health Counseling, LLC
• Michele Phulsuksombati, MS, MED,RD
• Physician'S Footwear
• Physiotherapy Associates Inc
• Yechen Pi
• John Dominic Piacentino, MD

• Surgery Physician in Frederick, MD
• Providers in Frederick, MD by specialty
• Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.