NPIMap

Organization Active NPI

Youngsik Moon, M.D., P.a.

Doing business as Hollywood Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Hollywood, MD
National Provider Identifier
1831203215
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
A1200 Issued in MD
Legal business name
YOUNGSIK MOON, M.D., P.A.
Doing business as
Hollywood Ambulatory Surgery Center
Practice address
24435 Mervell Dean Rd
Hollywood, MD 20636-2712
Phone
(301) 373-2116
Fax
(301) 373-5281
NPI assigned
Aug 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Betty Ann Quade
Title
Business Manager
Phone
(301) 373-2116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X A1200 MD Primary

Addresses

Primary practice location

24435 Mervell Dean Rd
Hollywood, MD 20636-2712

Mailing address

PO Box 37
Hollywood, MD 20636-0037
Phone (301) 373-2116

Other names 1

  • Hollywood Ambulatory Surgery Center Doing business as

National Provider Directory

National Provider Directory

Locations

24435 Mervell Dean Rd
Hollywood, MD 20636
Phone (301) 373-2116

Practitioners & affiliated clinicians

Practitioners 8

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": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831203215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206360037",
            "telephone_number": "301-373-2116",
            "fax_number": "301-373-5281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24435 MERVELL DEAN RD",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206362712",
            "telephone_number": "301-373-2116",
            "fax_number": "301-373-5281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNGSIK MOON, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "QUADE",
        "authorized_official_first_name": "BETTY ANN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "301-373-2116",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "A1200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hollywood Ambulatory Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hollywood, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.