Active NPI
Surgcenter of White Marsh, LLC
- Ambulatory Surgical Clinic/Center
- Baltimore, MD
National Provider Identifier
1962714154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- SURGCENTER OF WHITE MARSH, LLC
- Practice address
- 11605 Crossroads Cir
Baltimore, MD 21220-2865 - Phone
- (410) 344-0003
- Fax
- (410) 344-1330
- NPI assigned
- Jul 5, 2010
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
11605 Crossroads Cir
Baltimore, MD 21220-2865
Mailing address
14201 Dallas Pkwy
Dallas, TX 75254-2916
Phone (410) 344-0003
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
| CONNECT URL | https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Surgcenter of White Marsh LLC
- Medicare certification status
- Terminated Voluntary: merger or closure, Mar 24, 2023
National Provider Directory
National Provider DirectoryMember of 2
Organizations this organization is a member of, according to the National Provider Directory.
Locations
11605 Crossroads Cir
Ste Ac
Baltimore, MD 21220
Phone (410) 340-1171
11605 Crossroads Cir
Middle River, MD 21220
Phone (410) 344-0003
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Podiatrist
- Baltimore, MD
- NPI 1063449510
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278288000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1726531200000",
"number": "1962714154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14201 DALLAS PKWY",
"city": "DALLAS",
"state": "TX",
"postal_code": "752542916",
"telephone_number": "410-344-0003",
"fax_number": "410-344-1330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11605 CROSSROADS CIR",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212202865",
"telephone_number": "410-344-0003",
"fax_number": "410-344-1330"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SURGCENTER OF WHITE MARSH, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-07-05",
"last_updated": "2024-09-17",
"certification_date": "2024-09-17",
"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": null,
"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",
"address_1": "100 N 6th St Ste 900A",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554031516",
"country_name": "United States",
"address_type": "DOM"
},
{
"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",
"address_1": "100 N 6th St Ste 900A",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554031516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.