Active NPI
Potomac Urology Surgery Center, LLC
- Ambulatory Surgical Clinic/Center
- Oxon Hill, MD
National Provider Identifier
1629659800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- POTOMAC UROLOGY SURGERY CENTER, LLC
- Practice address
- 251 National Harbor Blvd # 400a
Oxon Hill, MD 20745-1052 - Phone
- (703) 680-2111
- Fax
- (703) 878-3939
- NPI assigned
- Apr 19, 2021
- Last updated
- Apr 19, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Pratik S Desai, MD
- Title
- President
- Phone
- (703) 680-2111
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | NU | Primary |
Addresses
Primary practice location
251 National Harbor Blvd # 400a
Oxon Hill, MD 20745-1052
Mailing address
2296 Opitz Blvd Ste 350
Woodbridge, VA 22191-3346
Phone (703) 680-2111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Potomac Urology Surgery Center LLC
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
251 National Harbor Blvd
#400A
Oxon Hill, MD 20745
Practitioners & affiliated clinicians
Practitioners 11
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618790400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1618790400000",
"number": "1629659800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2296 OPITZ BLVD STE 350",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221913346",
"telephone_number": "703-680-2111",
"fax_number": "703-680-2111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "251 NATIONAL HARBOR BLVD # 400A",
"city": "OXON HILL",
"state": "MD",
"postal_code": "207451052",
"telephone_number": "703-680-2111",
"fax_number": "703-878-3939"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "POTOMAC UROLOGY SURGERY CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-04-19",
"last_updated": "2021-04-19",
"certification_date": "2021-04-19",
"status": "A",
"authorized_official_last_name": "DESAI",
"authorized_official_first_name": "PRATIK",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "703-680-2111",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oxon Hill, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; 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.