Organization Active NPI

Deer Pointe Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Salisbury, MD
National Provider Identifier
1689986879
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
DEER POINTE SURGICAL CENTER, LLC
Doing business as
POA Surgery Center
Practice address
641 S Salisbury Blvd
Salisbury, MD 21801-5429
Phone
(410) 341-9002
Fax
(410) 341-9006
NPI assigned
Jul 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Authorized official

Name
Pasquale PetreraNPI 1215918933
Title
Authorized Official
Phone
(410) 749-4154

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 Primary

Addresses

Primary practice location

641 S Salisbury Blvd
Salisbury, MD 21801-5429

Mailing address

1675 Woodbrooke Dr
Salisbury, MD 21804-8502
Phone (410) 341-9002

Other names 1

  • POA Surgery Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100921001428 MD Part B Supplier - Ambulatory Surgical Center 5193841609 Practice locations: Salisbury, MD

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Deer Pointe Surgical Center LLCCCN 21C0001511
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2015560Poa Surgery Center641 S. Salisbury Blvd, Salisbury, MD 21801Certificate of waiverOct 28, 2026

National Provider Directory

National Provider Directory

Locations

6503 Deer Pointe Dr
Ste A
Salisbury, MD 21804
Phone (410) 341-9002

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1278288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1689986879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 WOODBROOKE DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218048502",
            "telephone_number": "410-341-9002",
            "fax_number": "410-341-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 S SALISBURY BLVD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015429",
            "telephone_number": "410-341-9002",
            "fax_number": "410-341-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEER POINTE SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-05",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A",
        "authorized_official_last_name": "PETRERA",
        "authorized_official_first_name": "PASQUALE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "410-749-4154"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "POA Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.