NPIMap

Organization Active NPI

Ambulatory Urology Surgical Center LLC

  • Urology Physician
  • Cumberland, MD
National Provider Identifier
1891022000
Registry record updated Dec 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
AMBULATORY UROLOGY SURGICAL CENTER LLC
Practice address
12234 Williams Rd
Cumberland, MD 21502
Phone
(301) 724-0132
Fax
(301) 759-5874
NPI assigned
Nov 9, 2009
Last updated
Dec 4, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2009

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

Authorized official

Name
Mrs. Kimberly Sue Folmer
Title
Billing MGR.
Phone
(301) 724-0132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X Primary

Addresses

Primary practice location

12234 Williams Rd
Cumberland, MD 21502

Mailing address

PO Box 419
12234 Williams Road
Cumberland, MD 21501-0419
Phone (301) 724-0132

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100201000611 MD Part B Supplier - Ambulatory Surgical Center 7911040852 Practice locations: Cumberland, MD

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Ambulatory Urology Surgical Center LLCCCN 21C0001262
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

12234 Williams Rd SE
Lavale, MD 21502
Phone (301) 723-4172

Practitioners & affiliated clinicians

Practitioners 3

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": "1257724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259884800000",
    "number": "1891022000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419",
            "address_2": "12234 WILLIAMS ROAD",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215010419",
            "telephone_number": "301-724-0132",
            "fax_number": "301-759-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12234 WILLIAMS RD",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "21502",
            "telephone_number": "301-724-0132",
            "fax_number": "301-759-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBULATORY UROLOGY SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-09",
        "last_updated": "2009-12-04",
        "status": "A",
        "authorized_official_last_name": "FOLMER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "BILLING MGR.",
        "authorized_official_telephone_number": "301-724-0132",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; 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.