Surgcenter of Glen Burnie

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SURGCENTER OF GLEN BURNIE

Doing business as

SurgCenter of Glen Burnie, LLC

Practice address

308 Hospital Dr
Ste 102
Glen Burnie, MD 21061

Phone

(410) 760-8100

Fax

(410) 760-8180

NPI assigned

Mar 31, 2008

Last updated

Jan 15, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jonathan Bailey

Title

Officer/Authorized Official

Phone

(203) 609-1168

Specialties & licenses 1

Addresses

Other names 1

• SurgCenter of Glen Burnie, LLC Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942472931. Details of each certification follow.

• CCN 210067 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 210067

Legal name

SURGCENTER OF GLEN BURNIE, LLC

Certification status

Terminated Other: provider status change, Apr 24, 2020

Provider type (POS)

Hospital – Short-term

Participating since

Apr 23, 2020

Last certification

Apr 23, 2020

Beds

1

Ownership / control type

Private (for profit)

Facility address

308 Hospital Drive, Suite 102
Glen Burnie, MD 21061

Listed as

Surgcenter of Glen Burnie LLCCCN 21C0001476

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• VHS San Antonio Partners LLC

  dba Baptist Health System

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

Practitioners 1

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.

• Bryan R Klepper, MD

  • Orthopaedic Surgery Physician
  • Glen Burnie, MD
  • NPI 1134101371
  NPD (past)

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1942472931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 HOSPITAL DR",
            "address_2": "STE 102",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-760-8100",
            "fax_number": "410-760-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 HOSPITAL DR",
            "address_2": "STE 102",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-760-8100",
            "fax_number": "410-760-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGCENTER OF GLEN BURNIE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-31",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "203-609-1168"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "SurgCenter of Glen Burnie, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SurgCenter of Glen Burnie, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Summit Peak Recovery LLC
• Eric R Sundel, M.D.
• Sung E. Kim, M.D., P.a.
• Sunstone (Balance & Birch)
• Kelsey Brianna Suppa, PA-C
• Surgical Assist Services LLC
• Juan A Suriel, MD
• Sushma Bhasin
• Sushma Bhasin (Sushma Bhasin MD)
• Jason Sutton

• Ambulatory Surgical Clinic/Center in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Ambulatory Surgical Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.