Meridian Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MERIDIAN SURGERY CENTER LLC

Practice address

19638 Leitersburg Pike Ste 205
Hagerstown, MD 21742-1515

Phone

(304) 263-6165

NPI assigned

May 9, 2020

Last updated

Sep 26, 2022By 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

Waheed S Baksh, MD, DPTNPI 1033393871

Title

Owner

Phone

(845) 325-6504

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528680865. Details of each certification follow.

• CCN 21C0001665 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 21C0001665

Legal name

Meridian Surgery Center, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Aug 31, 2023

Last certification

Aug 24, 2023

Ownership / control type

Proprietary

Facility address

19638 Leitersburg Pike, Suite 205
Hagerstown, MD 21742

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Waheed S Baksh, MD, DPT

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Winchester, VA
  • NPI 1033393871
  NPD Authorized official
• Kimberly Joy Waks, PA

  • Physician Assistant
  • Bridgeport, CT
  • NPI 1235603259
  NPD (past)
• Kristen Nicole Williams, PA-C

  • Medical Physician Assistant
  • Winchester, VA
  • NPI 1659835072
  NPD (past)

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

{
    "created_epoch": "1588982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664150400000",
    "number": "1528680865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 TAVERN RD STE 300",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012853",
            "telephone_number": "304-263-6165",
            "fax_number": "304-263-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19638 LEITERSBURG PIKE STE 205",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217421515",
            "telephone_number": "304-263-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-09",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A",
        "authorized_official_last_name": "BAKSH",
        "authorized_official_first_name": "WAHEED",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-325-6504",
        "authorized_official_credential": "MD, DPT"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Hagerstown, MD
• Providers in Hagerstown, 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 Sep 26, 2022; 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.