Smart Pain Surgery Center at Germantown, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

A1567 Issued in MD

Legal business name

SMART PAIN SURGERY CENTER AT GERMANTOWN, LLC

Doing business as

Clearway Surgery Center of Germantown

Practice address

19851 Observation Dr.
Suite 350
Germantown, MD 20876

Phone

(443) 693-7246

NPI assigned

Feb 9, 2015

Last updated

Jun 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ira D. Kornbluth, M.D.NPI 1609872266

Title

President

Phone

(855) 527-7246

Specialties & licenses 1

Addresses

Other names 1

• Clearway Surgery Center of Germantown Doing business as

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730570003. Details of each certification follow.

• CCN 21C0001567 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 21C0001567

Legal name

CLEARWAY SURGERY CENTER AT GERMANTOWN

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Feb 23, 2016

Last certification

Feb 23, 2016

Ownership / control type

Proprietary

Facility address

19851 Observation Drive, Suite 350
Germantown, MD 20876

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

CLIA laboratory certificates

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.

• Ira Kornbluth, M.D.

  • Interventional Pain Medicine Physician
  • Owings Mills, MD
  • NPI 1609872266
  NPD (past) Authorized official

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718755200000",
    "number": "1730570003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 DEFENSE HWY STE 205",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017096",
            "telephone_number": "855-527-7246",
            "fax_number": "866-229-5063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19851 OBSERVATION DR.",
            "address_2": "SUITE 350",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "20876",
            "telephone_number": "443-693-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMART PAIN SURGERY CENTER AT GERMANTOWN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-09",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A",
        "authorized_official_last_name": "KORNBLUTH",
        "authorized_official_first_name": "IRA",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "855-527-7246",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "A1567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clearway Surgery Center of Germantown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gina Sisti
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• Ashley Nicole Smith
• Da'Lesha Smith
• Laura-Lee Smith

• Ambulatory Surgical Clinic/Center in Germantown, MD
• Providers in Germantown, MD by specialty
• Ambulatory Surgical Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.