NPIMap

Organization Active NPI

Summit Ambulatory Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Baltimore, MD
National Provider Identifier
1649467630
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SUMMIT AMBULATORY SURGICAL CENTER, LLC
Practice address
5601 Loch Raven Blvd
Suite 307
Baltimore, MD 21239-2905
Phone
(410) 433-7303
Fax
(410) 433-7755
NPI assigned
Oct 3, 2007
Last updated
Jul 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Authorized official

Name
Dr. Sanford J. Siegel, M.D.NPI 1376506477
Title
President
Phone
(410) 581-1600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

5601 Loch Raven Blvd
Suite 307
Baltimore, MD 21239-2905

Mailing address

25 Crossroads Dr
Suite 306
Owings Mills, MD 21117-5421
Phone (443) 738-2872

Other identifiers 1

IdentifierTypeStateIssuer
800906607MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051121000159 MD Part B Supplier - Ambulatory Surgical Center 1355360280 16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Baltimore, MD; Owings Mills, MD; Salisbury, MD; Westminster, MD; Annapolis, MD

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory

Locations

5601 Loch Raven Blvd
Ste 307
Baltimore, MD 21239
Phone (410) 433-7303

Practitioners & affiliated clinicians

Practitioners 1

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": "1191369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469664000000",
    "number": "1649467630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CROSSROADS DR",
            "address_2": "SUITE 306",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175421",
            "telephone_number": "443-738-2872",
            "fax_number": "443-738-2713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "address_2": "SUITE 307",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392905",
            "telephone_number": "410-433-7303",
            "fax_number": "410-433-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT AMBULATORY SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-03",
        "last_updated": "2016-07-28",
        "status": "A",
        "authorized_official_last_name": "SIEGEL",
        "authorized_official_first_name": "SANFORD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-581-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800906607",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.