Organization Active NPI

Cumberland Valley Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Hagerstown, MD
National Provider Identifier
1881658524
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
A1380 Issued in MD
Legal business name
CUMBERLAND VALLEY SURGERY CENTER, LLC
Practice address
1110 Professional Boulevard
Suite 100
Hagerstown, MD 21740-5826
Phone
(240) 420-5559
Fax
(240) 420-3786
NPI assigned
Apr 12, 2006
Last updated
Mar 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Authorized official

Name
Richard Milford, MD
Title
Medical Director
Phone
(240) 420-5559

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X A1380 MD Primary

Addresses

Primary practice location

1110 Professional Boulevard
Suite 100
Hagerstown, MD 21740-5826

Mailing address

1110 Professional Boulevard
Suite 100
Hagerstown, MD 21740
Phone (405) 608-1700

Other identifiers 1

IdentifierTypeStateIssuer
404365100MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040429001451 MD Part B Supplier - Ambulatory Surgical Center 5597752543 Practice locations: Hagerstown, MD

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Cumberland Valley Surgery CenterCCN 21C0001380
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D1012034Cumberland Valley Surgery Center1110 Professional Court, Hagerstown, MD 21740Certificate of waiverApr 29, 2027

National Provider Directory

National Provider Directory

Locations

1110 Professional Ct
Ste 100
Hagerstown, MD 21740
Phone (240) 420-5559

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710115200000",
    "number": "1881658524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 PROFESSIONAL BOULEVARD",
            "address_2": "SUITE 100",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "21740",
            "telephone_number": "405-608-1700",
            "fax_number": "405-608-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 PROFESSIONAL BOULEVARD",
            "address_2": "SUITE 100",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405826",
            "telephone_number": "240-420-5559",
            "fax_number": "240-420-3786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND VALLEY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-12",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A",
        "authorized_official_last_name": "MILFORD",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "240-420-5559",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "A1380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404365100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.