NPIMap

Organization Active NPI

Medstar Medical Group - Southern Maryland LLC

  • Ambulatory Surgical Clinic/Center
  • Prince Frederick, MD
National Provider Identifier
1891626594
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
MEDSTAR MEDICAL GROUP - SOUTHERN MARYLAND LLC
Practice address
130 Hospital Drive
Ste 300
Prince Frederick, MD 20678-4057
Phone
(301) 373-7900
Fax
(301) 373-6900
NPI assigned
May 29, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Authorized official

Name
Alan Adair Buster Jr.
Title
C.O.O.
Phone
(301) 373-7905

Specialties & licenses 1

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

Addresses

Primary practice location

130 Hospital Drive
Ste 300
Prince Frederick, MD 20678-4057

Mailing address

24035 Three Notch Rd
Hollywood, MD 20636-4871
Phone (301) 373-7900

Other identifiers 1

IdentifierTypeStateIssuer
423411104MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Medstar Medical Group30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1780012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780012800000",
    "number": "1891626594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24035 THREE NOTCH RD",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206364871",
            "telephone_number": "301-373-7900",
            "fax_number": "301-373-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 HOSPITAL DRIVE",
            "address_2": "STE 300",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784057",
            "telephone_number": "301-373-7900",
            "fax_number": "301-373-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR MEDICAL GROUP - SOUTHERN MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-29",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A",
        "authorized_official_last_name": "BUSTER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "ADAIR",
        "authorized_official_title_or_position": "C.O.O.",
        "authorized_official_telephone_number": "301-373-7905",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "423411104",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; 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.