9106 Philadelphia Road Ambulatory Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

9106 PHILADELPHIA ROAD AMBULATORY SURGERY CENTER LLC

Practice address

9106 Philadelphia Rd
Suite 306
Baltimore, MD 21237

Phone

(410) 687-2656

Fax

(410) 687-3805

NPI assigned

Jan 4, 2008

Last updated

Apr 16, 2021By 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

Gabriel Martinez

Title

Owner/MD

Phone

(410) 687-2656

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942485305. Details of each certification follow.

• CCN 21C0001470 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 21C0001470

Legal name

9106 PHILADELPHIA ROAD ASC, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Sep 12, 2008

Last certification

Dec 3, 2019

Ownership / control type

Proprietary

Facility address

9106 Philadelphia Road, Suite 306
Baltimore, MD 21237

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.

• Gabriel a Martinez MD PA

  • Interventional Pain Medicine Physician
  • Baltimore, MD
  • NPI 1225213689

  Member Of

  NPD member

Locations

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.

• Gabriel A Martinez Geigel, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Baltimore, MD
  • NPI 1457481194
  NPD

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1942485305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9106 PHILADELPHIA RD",
            "address_2": "SUITE 306",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21237",
            "telephone_number": "410-687-2656",
            "fax_number": "410-687-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9106 PHILADELPHIA RD",
            "address_2": "SUITE 306",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21237",
            "telephone_number": "410-687-2656",
            "fax_number": "410-687-3805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "9106 PHILADELPHIA ROAD AMBULATORY SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-04",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "410-687-2656"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Baltimore, MD
• Providers in Baltimore, 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 Apr 16, 2021; 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.