NPIMap

Organization Active NPI

Suburban Hospital, Inc.

  • Radiation Oncology Clinic/Center
  • Bethesda, MD
National Provider Identifier
1528096690
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology Clinic/CenterTaxonomy code 261QX0203X
License
15332 Issued in MD
Legal business name
SUBURBAN HOSPITAL, INC.
Practice address
6420 Rockledge Dr
Suite 1200
Bethesda, MD 20817-7837
Phone
(301) 896-3901
NPI assigned
Jun 29, 2006
Organization subpart
Yes
Parent organization
SUBURBAN HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Authorized official

Name
Mr. Brian A. Gragnolati
Title
President
Phone
(301) 896-2574

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 15332 MD
Infusion Therapy Clinic/Center 261QI0500X 15332 MD
Radiation Oncology Clinic/Center 261QX0203X 15332 MD Primary

Addresses

Primary practice location

6420 Rockledge Dr
Suite 1200
Bethesda, MD 20817-7837

Mailing address

8600 Old Georgetown Rd
Bethesda, MD 20814-1422
Phone (301) 896-3901

Other identifiers 3

IdentifierTypeStateIssuer
715OtherDCBLUE CROSS OF NCA
419126900MedicaidMD
57352101OtherMDBLUE CROSS OF MARYLAND

Other names 1

  • Suburban Hospital Radiation Oncology Infusion Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091105000330 MD Part A Provider - Hospital 5395774368 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bethesda, MD

Hospital certification: CCN 210022

Legal name
SUBURBAN HOSPITAL, INC.
Doing business as
SUBURBAN HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 16, 2012
Beds
229
Ownership / control type
Private (not for profit)
Most recent change of ownership
Mar 14, 2006 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 1985 in MD
Enrollment address
8600 Old Georgtown Rd
Suburban Hospital
Bethesda, MD 20814-1497
Other Hospital Practice Location
Hospital subgroups
General

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Suburban HospitalCCN 210022
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Pulm Dis Suburban Hosp

Ownership & related parties

All disclosed owners & managing parties 29

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kimberly Elyanow Individual Corporate Officer Nov 1, 2023
Kevin K Sowers Individual Corporate Director Feb 1, 2018
Leo C Rotello Individual Corporate Director Jul 1, 2022
Lakmini Nanayakkara-Kidder Individual Corporate Officer Aug 31, 2020
Tiffany Pratt Individual Corporate Officer Nov 1, 2023
Jon Slabaugh Individual Corporate Director Jul 1, 2019
Lee Weinstein Individual Corporate Director Jul 1, 2020
Janine Lossing Individual Corporate Director Oct 12, 2018
Alvin D'Angelo Individual Corporate Officer Oct 17, 2022
Michael a Smith Individual Corporate Director Oct 6, 2017
Cindy Merz Individual Corporate OfficerVice President, Development Jun 1, 2021
The Johns Hopkins Health System Corporation Organization, Baltimore, MD Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2009 100%
Vadim M. Schick Individual Corporate Officer Jul 1, 2022
Mary Ellen Beliveau Individual Corporate Director Oct 6, 2017
Lara Eisenberg Individual Corporate Director Jul 1, 2022
Carolyn Carpenter Individual Corporate OfficerTrustee Jun 1, 2021
Sarah Johnson Conway Individual Corporate Director Nov 1, 2023
Mark Edward Futrovsky Individual Corporate DirectorBoard Member Jul 1, 2016
Leighann Sidone Individual Corporate OfficerPresident Jan 27, 2016
W-2 Managing Employee Feb 5, 2024
Brian W Cobb Individual Corporate Officer Oct 6, 2017
Pamela T Owens Individual Corporate OfficerChief Compliance Officer Jul 1, 2017
W-2 Managing Employee Jul 1, 2017
Anu Mullick Individual Corporate Officer May 21, 2023
George Cheely Individual Corporate Officer Nov 1, 2023
David Ruben Individual Corporate DirectorBoard Member Jul 1, 2016
Linda V Courie Individual Corporate Officer Oct 6, 2017
Jonathan E Efron Individual Corporate Director Jan 1, 2018
Barton W Leonard Individual Corporate Director Jul 1, 2018
Elizabeth Flanagan Individual Corporate Director Jul 1, 2019
Peter B Mancino Individual Corporate OfficerVice President of Compliance del Jul 1, 2017
W-2 Managing Employee Jul 1, 2017

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 553

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 553

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1528096690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 OLD GEORGETOWN RD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208141422",
            "telephone_number": "301-896-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 ROCKLEDGE DR",
            "address_2": "SUITE 1200",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208177837",
            "telephone_number": "301-896-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUBURBAN HOSPITAL, INC.",
        "enumeration_date": "2006-06-29",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "GRAGNOLATI",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-896-2574",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MD",
            "license": "15332",
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "MD",
            "license": "15332",
            "primary": false
        },
        {
            "code": "261QX0203X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oncology, Radiation",
            "state": "MD",
            "license": "15332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF NCA",
            "identifier": "715",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "419126900",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MARYLAND",
            "identifier": "57352101",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Suburban Hospital Radiation Oncology Infusion Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.