NPIMap

Organization Active NPI

Annapolis ENT Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Annapolis, MD
National Provider Identifier
1629094917
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
A1360 Issued in MD
Legal business name
ANNAPOLIS ENT SURGICAL CENTER, LLC
Practice address
2002 Medical Pkwy Ste 150
Annapolis, MD 21401-3159
Phone
(410) 266-6267
Fax
(410) 266-8962
NPI assigned
Jul 13, 2006
Last updated
Jun 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Authorized official

Name
Matthew Alexander Hilburn, MDNPI 1629036538
Title
Medical Director
Phone
(410) 841-5279

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X A1360 MD Primary

Addresses

Primary practice location

2002 Medical Pkwy Ste 150
Annapolis, MD 21401-3159

Mailing address

2002 Medical Pkwy Ste 150
Annapolis, MD 21401-3159
Phone (410) 266-6267

Other identifiers 1

IdentifierTypeStateIssuer
400841300MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080927000220 MD Part B Supplier - Ambulatory Surgical Center 9436226750 Practice locations: Annapolis, MD

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Annapolis ENT Surgical Center LLCCCN 21C0001360
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Annapolis ENT Surgical Center LLC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 50

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.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750636800000",
    "number": "1629094917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY STE 150",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013159",
            "telephone_number": "410-266-6267",
            "fax_number": "410-266-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY STE 150",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013159",
            "telephone_number": "410-266-6267",
            "fax_number": "410-266-8962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNAPOLIS ENT SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A",
        "authorized_official_last_name": "HILBURN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "410-841-5279",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "A1360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400841300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.