Maplewood Ambulatory Surgery Center, Inc.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

000388 Issued in TX

Legal business name

MAPLEWOOD AMBULATORY SURGERY CENTER, INC.

Practice address

4301 Maplewood Avenue
Suite C
Wichita Falls, TX 76308

Phone

(940) 696-8548

Fax

(940) 696-8546

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark A Workman, M.D.NPI 1447238415

Title

President

Phone

(940) 696-8500

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Maplewood Ambulatory Surgery Center IncCCN 45C0001241

Medicare certification status

ActiveFrom the Provider of Services file

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 2

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.

• Mark Workman, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Wichita Falls, TX
  • NPI 1447238415
  Authorized official Same address or phone
• Marcom Earl Herren, D.O.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Wichita Falls, TX
  • NPI 1326064825
  NPD (past)

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527552000000",
    "number": "1861418378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 MAPLEWOOD AVENUE",
            "address_2": "SUITE C",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763083879",
            "telephone_number": "940-696-8548",
            "fax_number": "940-696-8546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 MAPLEWOOD AVENUE",
            "address_2": "SUITE C",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "76308",
            "telephone_number": "940-696-8548",
            "fax_number": "940-696-8546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLEWOOD AMBULATORY SURGERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2018-05-29",
        "status": "A",
        "authorized_official_last_name": "WORKMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "940-696-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "000388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0879546-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX STATE LICENSE #",
            "identifier": "000388",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mamad Bagheri MD PA
• Managing Life Mental Health Clinic LLC
• Magan Nicole Mangold, LPC
• Darby J Mankins
• Danielle Elaine Mansfield, LCSW
• Maplewood Eyecare Center (Larry D Gunnell OD)
• Tanna Marak
• Jamael Marcelle, MS, LPC
• Adam Roland Marchand, PHYSICAL THERAPIST
• Stefanie Janine Marco, MD

• Ambulatory Surgical Clinic/Center in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.