NPIMap

Organization Active NPI

Peninsula Surgical Group, PA

  • Family Nurse Practitioner
  • Salisbury, MD
National Provider Identifier
1780011312
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R180523 Issued in MD
Legal business name
PENINSULA SURGICAL GROUP, PA
Practice address
145 E Carroll St
Salisbury, MD 21801-5454
Phone
(410) 548-2600
NPI assigned
Sep 27, 2013
Last updated
Sep 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Authorized official

Name
John A Bartkovich, MDNPI 1932181450
Title
Secretary/Treasurer
Phone
(410) 548-2600

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
Family Nurse Practitioner 363LF0000X R180523 MD Primary

Addresses

Primary practice location

145 E Carroll St
Salisbury, MD 21801-5454

Mailing address

804 Snow Hill Rd
Salisbury, MD 21804-1938
Phone (410) 548-2600

National Provider Directory

National Provider Directory
Tax ID family
Peninsula Surgical Group PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1380240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380240000000",
    "number": "1780011312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SNOW HILL RD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218041938",
            "telephone_number": "410-548-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015454",
            "telephone_number": "410-548-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA SURGICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-27",
        "last_updated": "2013-09-27",
        "status": "A",
        "authorized_official_last_name": "BARTKOVICH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "410-548-2600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R180523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.