NPIMap

Organization Active NPI

Colon Rectal Surgical Associates, LLC

  • Colon & Rectal Surgery Physician
  • Ellicott City, MD
National Provider Identifier
1831150234
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
Legal business name
COLON RECTAL SURGICAL ASSOCIATES, LLC
Practice address
4801 Dorsey Hall Dr Ste 216
Ellicott City, MD 21042-7749
Phone
(410) 730-1712
Fax
(410) 730-1713
NPI assigned
Mar 28, 2006
Last updated
Dec 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

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

Authorized official

Name
Dr. James Joseph Zalucki, MDNPI 1760485353
Title
Administrator
Phone
(410) 707-1586

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
Colon & Rectal Surgery Physician 208C00000X Primary

Addresses

Primary practice location

4801 Dorsey Hall Dr Ste 216
Ellicott City, MD 21042-7749

Mailing address

4801 Dorsey Hall Dr Ste 216
Ellicott City, MD 21042-7749
Phone (410) 730-1712

Other practice location 1

25 Crossroads Dr
Suite 312
Owings Mills, MD 21117-5421
Phone (410) 363-6664

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040616001510 MD Part B Supplier - Clinic/Group Practice 9032193040 Receives reassigned benefits from 3 practitioners
Practice locations: Ellicott City, MD; Glen Burnie, MD

National Provider Directory

National Provider Directory

Locations

301 Saint Paul St
Ste 400
Baltimore, MD 21202
Phone (410) 783-5800

405 Frederick Rd
Ste 202
Catonsville, MD 21228
Phone (410) 363-6664

7211 Bank Ct
Ste 140
Frederick, MD 21703
Phone (410) 363-6664

1600 Crain Hwy S
Ste 409
Glen Burnie, MD 21061
Phone (410) 760-9996

7501 Osler Dr
Ste 204
Towson, MD 21204
Phone (410) 296-5715

Practitioners & affiliated clinicians

Practitioners 11

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": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544486400000",
    "number": "1831150234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR STE 216",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427749",
            "telephone_number": "410-730-1712",
            "fax_number": "410-730-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR STE 216",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427749",
            "telephone_number": "410-730-1712",
            "fax_number": "410-730-1713"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Crossroads Dr",
            "address_2": "Suite 312",
            "address_purpose": "LOCATION",
            "city": "Owings Mills",
            "state": "MD",
            "postal_code": "211175421",
            "country_code": "US",
            "telephone_number": "410-363-6664",
            "fax_number": "410-363-7186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COLON RECTAL SURGICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2018-12-11",
        "status": "A",
        "authorized_official_last_name": "ZALUCKI",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "410-707-1586",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.