NPIMap

Organization Active NPI

Prestige Plastic Surgery, LLC

  • Plastic Surgery Physician
  • Columbia, MD
National Provider Identifier
1598820136
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
D0063900 Issued in MD
Legal business name
PRESTIGE PLASTIC SURGERY, LLC
Practice address
8600 Snowden River Pkwy
Suite 308
Columbia, MD 21045-1982
Phone
(410) 290-1696
NPI assigned
Dec 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Authorized official

Name
Dr. Gary Anthony Vela, M.D.
Title
President
Phone
(410) 290-1696

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X D0063900 MD Primary

Addresses

Primary practice location

8600 Snowden River Pkwy
Suite 308
Columbia, MD 21045-1982

Mailing address

8600 Snowden River Pkwy
Suite 308
Columbia, MD 21045-1982
Phone (410) 290-1696

Other identifiers 1

IdentifierTypeStateIssuer
30PZGAOtherMDBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

8600 Snowden River Pkwy
Ste 308
Columbia, MD 21045
Phone (410) 290-1696

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1598820136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 SNOWDEN RIVER PKWY",
            "address_2": "SUITE 308",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210451982",
            "telephone_number": "410-290-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 SNOWDEN RIVER PKWY",
            "address_2": "SUITE 308",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210451982",
            "telephone_number": "410-290-1696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE PLASTIC SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "VELA",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-290-1696",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "MD",
            "license": "D0063900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "30PZGA",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.