NPIMap

Organization Active NPI

Bethesda Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Bethesda, MD
National Provider Identifier
1770572307
Registry record updated Aug 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
A1130 Issued in MD
Legal business name
BETHESDA SURGERY CENTER, LLC
Practice address
10215 Fernwood Rd
Suite 412
Bethesda, MD 20817-1106
Phone
(301) 530-6100
Fax
(301) 530-6104
NPI assigned
Oct 17, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2008

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

Authorized official

Name
Dr. Roger J Oldham, M.D.NPI 1861488611
Title
Medical Director
Phone
(301) 530-6100

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 A1130 MD Primary

Addresses

Primary practice location

10215 Fernwood Rd
Suite 412
Bethesda, MD 20817-1106

Mailing address

10215 Fernwood Rd
Suite 412
Bethesda, MD 20817-1106
Phone (301) 530-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 21C0001130

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
BETHESDA SURGERY CENTER
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Jun 21, 1994
Last certification
Aug 22, 2019
Ownership / control type
Proprietary
Facility address
10215 Fernwood Road #412
Bethesda, MD 20817

National Provider Directory

National Provider Directory

Locations

10215 Fernwood Rd
Ste 412
Bethesda, MD 20817
Phone (301) 530-6100

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": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219795200000",
    "number": "1770572307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10215 FERNWOOD RD",
            "address_2": "SUITE 412",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208171106",
            "telephone_number": "301-530-6100",
            "fax_number": "301-530-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10215 FERNWOOD RD",
            "address_2": "SUITE 412",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208171106",
            "telephone_number": "301-530-6100",
            "fax_number": "301-530-6104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHESDA SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2008-08-27",
        "status": "A",
        "authorized_official_last_name": "OLDHAM",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "301-530-6100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "A1130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.