SURGICAL ASSOCIATES, CHARTERED (NPI# 1548406960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548406960 |
| Entity Type | Organization |
| Organization Name | SURGICAL ASSOCIATES, CHARTERED |
| Practice Address |
12070 Old Line Ctr Suite 306 Waldorf MD 20602-2513 |
| Mailing Address |
7501 Surratts Rd Suite 303 Clinton MD 20735-3362 |
| Practice Telephone | 3018688485 |
| Practice Fax Number | 3018680638 |
| Mailing Telephone | 3018688485 |
| Mailing Fax Number | 3018680638 |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2009-01-07 |
| Authorized Official Name | MICHELLE BURTON (CREDENTIALING/CONTRACTS MANAGER) |
| Authorized Official Telephone | 3018688485 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | H0061922 | MD | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | D0059944 | MD | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | D26021 | MD | Allopathic & Osteopathic Physicians |
| N | 363A00000X | Physician Assistant | C0003134 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
R119098 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
D24644 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UPIN | E93554 | 01 | |
| UPIN | B66909 | 01 | |
| UPIN | C62030 | 01 | |
| UPIN | H04537 | 01 | |
| UPIN | H43765 | 01 | |
| UPIN | S98671 | 01 | |
| UPIN | B94310 | 01 | |
| UPIN | C76566 | 01 | |
| UPIN | B94699 | 01 | |
| UPIN | C62118 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437104767 | Surgical Associates, Chartered | Surgery | 7335 Hanover Pkwy, Suite B, Greenbelt, MD 20770-3623 | 2006-05-24 |
| 1922251669 | Surgical Associates, Chartered | Surgery | 5801 Allentown Rd, Suite 502, Camp Springs, MD 20746-4563 | 2008-10-28 |
| 1831342575 | Surgical Associates, Chartered | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 6510 Kenilworth Ave, Suite 1100, Riverdale, MD 20737-1339 | 2008-10-28 |
| 1770742082 | Surgical Associates, Chartered | Surgery | 6357 Oxon Hill Rd, Oxon Hill, MD 20745-2214 | 2008-06-03 |
| 1194900068 | Surgical Associates, Chartered | Surgery | 6510 Kenilworth Ave, Suite 2100, Riverdale, MD 20737-1339 | 2008-01-09 |
| 1508931551 | Surgical Associates, Chartered | Surgery | 3510 Old Washington Rd, Waldorf, MD 20602-3233 | 2006-11-22 |
| 1861447401 | Surgical Associates, Chartered | Surgery | 11340 Pembrooke Sq, Suite 213, Waldorf, MD 20603-4808 | 2006-05-23 |
| Street Address |
12070 OLD LINE CTR SUITE 306 |
| City | WALDORF |
| State | MD |
| Zip Code | 20602-2513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942206412 | Douglas Avery & Associates Ltd | Clinic/Center | 12070 Old Line Ctr, Ste 107, Waldorf, MD 20602-2503 | 2005-06-21 |
| 1104467463 | Maryland Pain & Regenerative Center, LLC | Pain Medicine | 12070 Old Line Ctr, Waldorf, MD 20602-2513 | 2019-10-07 |
| 1578947305 | Larry S. Hotchkiss, Dpm PC | Non-Pharmacy Dispensing Site | 12070 Old Line Ctr, #110, Waldorf, MD 20602-2513 | 2015-07-10 |
| 1851791735 | Pro-perform Spinal Health & Rehab LLC | Chiropractor | 12070 Old Line Ctr, Suite 301, Waldorf, MD 20602-2513 | 2014-08-28 |
| 1427494343 | Denise Colton | Nurse Practitioner | 12070 Old Line Ctr, Suite 302, Waldorf, MD 20602-2513 | 2013-05-18 |
| 1659636082 | Justin G. Pointer | Podiatrist | 12070 Old Line Ctr, Suite 110, Waldorf, MD 20602-2513 | 2012-07-11 |
| 1538437223 | Christine T Gardella | Physician Assistant | 12070 Old Line Ctr, Suite 302, Waldorf, MD 20602-2513 | 2011-12-08 |
| 1265670046 | Dawn Stephanie Christopher | Internal Medicine | 12070 Old Line Ctr, Suite 303, Waldorf, MD 20602-2513 | 2009-02-02 |
| 1386812113 | Elizabeth Hurt | Internal Medicine | 12070 Old Line Ctr, Suite 303, Waldorf, MD 20602-2513 | 2008-02-14 |
| 1861682957 | Gowri Kularatna | Internal Medicine | 12070 Old Line Ctr, Suite 200, Waldorf, MD 20602-2513 | 2007-07-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053964957 | Haeyoung Choi | Pharmacist | 25 Smallwood Village Center, Waldorf, MD 20602 | 2019-07-19 |
| 1679137194 | Brighter Days Family Services Inc | Counselor | 11680 Doolittle Dr #111, Waldorf, MD 20602 | 2019-04-30 |
| 1396227039 | Lantern Family Services Inc | Community/Behavioral Health | 11680 Doolittle Dr Ste 111, Waldorf, MD 20602 | 2018-08-29 |
| 1093294910 | Metropolitan Vascular Institute LLC | Internal Medicine | 12070 Old Line Ctr Ste 100, Waldorf, MD 20602 | 2018-08-10 |
| 1174009922 | Dr. Arthur B. Sorkin, D.d.s., LLC | Dentist | 3460 Old Washington Rd., Suite 301-b, Waldorf, MD 20602 | 2018-07-16 |
| 1467945030 | Donna Marie Conley-shaw | Behavior Technician | 16 Pagnell Cir, Waldorf, MD 20602 | 2018-06-08 |
| 1811404296 | Loni Berbaum | Speech-Language Pathologist | 4817 Elmley Pl Apt 315, Waldorf, MD 20602 | 2018-01-06 |
| 1891224853 | Linda E Smith | Social Worker | 605 Pst Office Road, #301, Waldorf, MD 20602 | 2017-06-05 |
| 1104373273 | Love Ngum Che | Pharmacist | 25 Smallwood Village, Waldorf, MD 20602 | 2016-09-07 |
| 1639543341 | Matengy Toure | Pharmacist | 129 St Charles Pkwy, Waldorf, MD 20602 | 2015-11-18 |
| Find all providers in zip 20602 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730480872 | James F Mcguckin Md of Md Pa | Surgery | 3450 Old Washington Rd Ste 202, Waldorf, MD 20602-3250 | 2010-11-05 |
| 1508931551 | Surgical Associates, Chartered | Surgery | 3510 Old Washington Rd, Waldorf, MD 20602-3233 | 2006-11-22 |
| 1861447401 | Surgical Associates, Chartered | Surgery | 11340 Pembrooke Sq, Suite 213, Waldorf, MD 20603-4808 | 2006-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326678731 | Nova Vascular Specialists, LLC | Surgery | 1952 Pulaski Hwy Ste B-2, Edgewood, MD 21040-1658 | 2020-01-24 |
| 1033683339 | Vein and Vascular Institute of Central Maryland | Surgery | 1300 York Rd Ste 200, Lutherville, MD 21093-6090 | 2019-01-20 |
| 1932651312 | Elham Oumer | Surgery | 8730 Cherry Ln Ste 10, Laurel, MD 20707-6212 | 2016-11-01 |
| 1255742961 | Marta Vismer | Surgery | 19942 Gateshead Cir, Germantown, MD 20876-6311 | 2014-05-15 |
| 1023448305 | Samer Saiedy Md Gb LLC | Surgery | 1811 Crain Hwy S, Glen Burnie, MD 21061-5561 | 2013-11-22 |
| 1285077289 | Lucy Kupersmith | Surgery | 2002 Medical Pkwy Ste 502, Annapolis, MD 21401 | 2013-04-10 |
| 1316227150 | Joshua Dearing | Surgery | 7503 Surratts Rd Ste 208, Clinton, MD 20735-3358 | 2011-08-25 |
| 1861782492 | Norman Anthony Odyniec | Surgery | 9208 Levelle Dr, Chevy Chase, MD 20815-5604 | 2011-04-16 |
| 1194952796 | James M Salander, Md Pa | Surgery | 11119 Rockville Pile, #204, Rockville, MD 20852 | 2009-06-22 |
| 1275783292 | William Herman Rogers | Surgery | 38 Arundel Rd, Annapolis, MD 21401-1206 | 2008-09-26 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SURGICAL ASSOCIATES, CHARTERED.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.