NPIMap

Organization Active NPI

Platinum Surgical Assistants

  • Surgical Technologist
  • Fulton, MD
National Provider Identifier
1962824896
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical TechnologistTaxonomy code 246ZS0410X
License
3077 Issued in MD
Legal business name
PLATINUM SURGICAL ASSISTANTS
Practice address
8115 Maple Lawn Blvd Ste 350
Fulton, MD 20759-2683
Phone
(301) 363-4934
NPI assigned
Jan 12, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Authorized official

Name
Mr. Rafael J Nollie, CSA/LPNNPI 1447459854
Title
President
Phone
(301) 363-4934

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193200000X MULTI-SPECIALTY GROUP 164W00000X LP49426 MD
Surgical TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 246ZS0410X 3077 MD Primary

Addresses

Primary practice location

8115 Maple Lawn Blvd Ste 350
Fulton, MD 20759-2683

Mailing address

3570 Olney Laytonsville Rd Unit 71
Olney, MD 20830-7503
Phone (301) 363-4934

National Provider Directory

National Provider Directory

Locations

3470 Olney Laytonsville Rd
Olney, MD 20832
Phone (301) 363-4934

3570 Olney Laytonsville Rd
Unit 71
Olney, MD 20830
Phone (301) 363-4934

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1389484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686614400000",
    "number": "1962824896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3570 OLNEY LAYTONSVILLE RD UNIT 71",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208307503",
            "telephone_number": "301-363-4934",
            "fax_number": "301-363-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8115 MAPLE LAWN BLVD STE 350",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592683",
            "telephone_number": "301-363-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATINUM SURGICAL ASSISTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-12",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A",
        "authorized_official_last_name": "NOLLIE",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-363-4934",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CSA/LPN"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "MD",
            "license": "LP49426",
            "primary": false
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "MD",
            "license": "3077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.