Summit Ambulatory Surgical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SUMMIT AMBULATORY SURGICAL CENTER, LLC

Practice address

3801 International Dr
Suite 300
Silver Spring, MD 20906-1550

Phone

(301) 598-9717

Fax

(301) 598-3230

NPI assigned

Sep 23, 2011

Last updated

Jan 14, 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 identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Summit Ambulatory Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Bel Air, MD
  • NPI 1538390539

  1355360280

  Same PAC ID
• Summit Ambulatory Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Baltimore, MD
  • NPI 1588610190

  1355360280

  Same PAC ID
• Summit Ambulatory Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Brandywine, MD
  • NPI 1659793040

  1355360280

  Same PAC ID
• Summit Ambulatory Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Columbia, MD
  • NPI 1912434697

  1355360280

  Same PAC ID

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Summit Ambulatory Surgical Center LLC

  • Ambulatory Surgical Clinic/Center
  • Germantown, MD
  • NPI 1134613979

  O20120306000054

  Same enrollment
• Summit Ambulatory Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Potomac, MD
  • NPI 1649707324

  O20120306000054

  Same enrollment

Listed as

Summit Ambulatory Surgical Center LLCCCN 21C0001362

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

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1972886190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14201 DALLAS PKWY STE 306",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752542916",
            "telephone_number": "469-872-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 INTERNATIONAL DR",
            "address_2": "SUITE 300",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209061550",
            "telephone_number": "301-598-9717",
            "fax_number": "301-598-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT AMBULATORY SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-23",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800906618",
            "state": "MD"
        }
    ],
    "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": []
}

• Sarah Sullivan, LCSW-C
• Ghousia Sultana, M.D.
• Sumana Kafle DDS, LLC (Silver Spring Pediatric Dentistry)
• Sumesh Potluri DMD MSD PC (Silver Spring Endodontics)
• Jeff Lee Summers, M.D.
• Summit Hills MD Opco (Fox Chase Healthcare)
• Summit Speech & Language Therapy
• Su-Lin Sun, PHARM.D.
• Sunbeam Care Rehab Services LLC
• Jungeun Sung, RN

• Ambulatory Surgical Clinic/Center in Silver Spring, MD
• Providers in Silver Spring, 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 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.