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SUMMIT AMBULATORY SURGICAL CENTER, LLC
NPI 1205023280
Clinic/Center - Ambulatory Surgical in Baltimore, MD

Active since October 03, 2007CLIA 21D1102721 · Waiver
3407 WILKENS AVE, SUITE 200, BALTIMORE, MD 21229(410) 644-0929(410) 644-4338 Get Directions Write a Review

NPPES record last updated: January 14, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 7, 2025, Feb 9, 2023, Aug 17, 2022 (3 updates tracked since 2022).

About Summit Ambulatory Surgical Center, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUMMIT AMBULATORY SURGICAL CENTER, LLC (NPI 1205023280) is a healthcare organization registered as an ambulatory surgical in Baltimore, Maryland and active in the NPI registry since October 2007. The organization holds a CLIA Waiver certificate valid through July 22, 2027 and lists Jonathan Bailey, Officer/authorized Official, as its authorized official.

NPPES Registry Identity

NPI1205023280
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameSUMMIT AMBULATORY SURGICAL CENTER, LLC
Location Address3407 WILKENS AVE, SUITE 200Baltimore, MD 21229-5072
Mailing Address14201 Dallas Pkwy Ste 306Dallas, TX 75254-2916 · (469) 872-4706
Phone(410) 644-0929
Fax(410) 644-4338
Organization SubpartNo
Authorized OfficialJonathan BaileyOfficer/authorized Official · (203) 609-1168
Enumeration DateOctober 3, 2007
Last NPPES UpdateJanuary 14, 20253 updates tracked since enumeration
NPPES CertifiedJanuary 14, 2025
✔ NPI 1205023280 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
3407 WILKENS AVE, Baltimore, MD 21229
Open in Google Maps ↗

Other Identifiers 1

Medicaid800906603MD

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D1102721

Summit Ambulatory Surgical Center LLC · Baltimore, MD
Active · expires Jul 22, 2027
CLIA Number21D1102721
Laboratory TypePhysician Office
Certificate Effective DateJuly 23, 2025
Certificate Expiration DateJuly 22, 2027
Laboratory DirectorBrad D. Lerner MD
Laboratory Phone(410) 644-0929
Laboratory LocationSummit Ambulatory Surgical Center LLC3407 Wilkens Ave #200, Baltimore, MD 21229
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, onabotulinumtoxina, 1 unit J0585
Onabotulinumtoxina, also known as Botox, is a medication injected into muscles. It's used to treat various conditions by blocking nerve activity in the muscles, causing a temporary reduction in muscle activity. The units refer to the dosage.
7,700 services28 patients
Diagnostic exam of bladder and urethra using an endoscope 52000
This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.
356 services326 patients
Insertion of sacral nerve neurostimulator electrode array 64561
The insertion of a sacral nerve neurostimulator electrode array is a procedure where a small device is placed under your skin. This device sends mild electrical pulses to your sacral nerves, which can help manage certain body functions and alleviate symptoms.
58 services27 patients
Ultrasound scan of pelvic region through rectum 76872
An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.
55 services55 patients
Biopsy of prostate gland 55700
A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.
48 services48 patients
Exam with injections of chemical for destruction of bladder using an endoscope 52287
This procedure involves the use of a thin, flexible tube with a light (endoscope) for internal examination. A chemical is then injected to help eliminate specific issues in the bladder. It's a standard and safe process.
40 services30 patients

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANDREA BRADY
Registered Nurse (Ambulatory Care)
3407 WILKENS AVE
BALTIMORE, MD 21229
Baltimore City (410) 644-0929
MATTHEW R VOSS MD
Internal Medicine (Interventional Cardiology)
3407 WILKENS AVE, SUITE 300
BALTIMORE, MD 21229
Baltimore City (410) 644-5111
UNIVERSITY OF MARYLAND SURGICAL ASSOCIATES, PA
Urology
3407 WILKENS AVE
BALTIMORE, MD 21229
Baltimore City (410) 328-5544
CONRAD J DUNCAN M.D.
Obstetrics & Gynecology (Gynecology)
3407 WILKENS AVE, SUITE 210
BALTIMORE, MD 21229
Baltimore City (410) 644-0929
SHANNON J WINAKUR M.D.
Internal Medicine (Cardiovascular Disease)
3407 WILKENS AVE, SUITE 300
BALTIMORE, MD 21229
Baltimore City (410) 644-5111
PETER S FILDERMAN MD
Urology
3407 WILKENS AVE, SUITE 210
BALTIMORE, MD 21229
Baltimore City (410) 644-0929
DR. FREDERICK E. KUHN JR. M.D.
Internal Medicine (Cardiovascular Disease)
3407 WILKENS AVE, SUITE 300
BALTIMORE, MD 21229
Baltimore City (410) 644-5111
RAYMOND H. PLACK JR. M.D.
Internal Medicine (Interventional Cardiology)
3407 WILKENS AVE, SUITE 300
BALTIMORE, MD 21229
Baltimore City (410) 644-5111

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Summit Ambulatory Surgical Center, LLC's NPI number?

The NPI number for Summit Ambulatory Surgical Center, LLC is 1205023280. It was assigned to this organization in the NPPES registry on October 3, 2007.

Where is Summit Ambulatory Surgical Center, LLC located?

Summit Ambulatory Surgical Center, LLC is located at 3407 Wilkens Ave Suite 200, Baltimore, MD 21229. The listed phone number is (410) 644-0929.

What is Summit Ambulatory Surgical Center, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Summit Ambulatory Surgical Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D1102721) is associated with this NPI, valid through July 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Summit Ambulatory Surgical Center, LLC was last updated on January 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.