Organization Active NPI

Belcrest Surgery Center, LLC

  • Podiatrist
  • Hyattsville, MD
National Provider Identifier
1720128929
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
01450 Issued in MD
Legal business name
BELCREST SURGERY CENTER, LLC
Practice address
6505 Belcrest Rd
Suite 1
Hyattsville, MD 20782-2011
Phone
(301) 699-5900
Fax
(301) 699-9297
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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

Authorized official

Name
Johny Motran, D.P.M.
Title
Manager/Leading Memb
Phone
(301) 699-5900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X
PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213E00000X 01450 MD Primary

Addresses

Primary practice location

6505 Belcrest Rd
Suite 1
Hyattsville, MD 20782-2011

Mailing address

PO Box 86284
Montgomery Village, MD 20886-6284
Phone (301) 699-5900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140311001192 DC Part B Supplier - Ambulatory Surgical Center 0244460392 Practice locations: Hyattsville, MD

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Belcrest Surgery CenterCCN 21C0001163
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

6505 Belcrest Rd
Ste 1
Hyattsville, MD 20782
Phone (202) 964-1160

Practitioners & affiliated clinicians

Practitioners 1

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": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392854400000",
    "number": "1720128929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86284",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208866284",
            "telephone_number": "301-699-5900",
            "fax_number": "301-699-9297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 BELCREST RD",
            "address_2": "SUITE 1",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207822011",
            "telephone_number": "301-699-5900",
            "fax_number": "301-699-9297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELCREST SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2014-02-20",
        "status": "A",
        "authorized_official_last_name": "MOTRAN",
        "authorized_official_first_name": "JOHNY",
        "authorized_official_title_or_position": "MANAGER/LEADING MEMB",
        "authorized_official_telephone_number": "301-699-5900",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "01450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; 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.