MARYLAND AMBULATORY SURGERY CENTER LLC
NPI 1487280871
Clinic/Center - Ambulatory Surgical in Lanham, MD

Q: What is Maryland Ambulatory Surgery Center LLC's specialty?

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

Active since March 17, 2020CLIA 21D2218974 · Waiver

7501 FORBES BLVD STE 103, LANHAM, MD 20706(202) 498-1125(240) 770-0436 Get Directions Write a Review

NPPES record last updated: June 30, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jun 30, 2021, Sep 16, 2020, Mar 17, 2020 (3 updates tracked since 2020).

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About Maryland Ambulatory Surgery Center Llc NPPES

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

MARYLAND AMBULATORY SURGERY CENTER LLC (NPI 1487280871) is a healthcare organization registered as an ambulatory surgical in Lanham, Maryland and active in the NPI registry since March 2020. The organization holds a CLIA Waiver certificate valid through March 31, 2027 and lists Tristan Shockley, Owner, as its authorized official.

NPPES Registry Identity

NPI1487280871

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameMARYLAND AMBULATORY SURGERY CENTER LLC

Location Address7501 FORBES BLVD STE 103Lanham, MD 20706-6201

Mailing Address7501 Forbes Blvd Ste 103Lanham, MD 20706-6201 · (301) 850-4401 · Fax (301) 850-4402

Phone(202) 498-1125

Fax(240) 770-0436

Organization SubpartNo

Authorized OfficialTristan ShockleyOwner · (301) 850-4401

Enumeration DateMarch 17, 2020

Last NPPES UpdateJune 30, 20213 updates tracked since enumeration

NPPES CertifiedJune 30, 2021

✔ NPI 1487280871 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities

Taxonomy Code261QA1903X

7501 FORBES BLVD STE 103, Lanham, MD 20706

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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Maryland Ambulatory Surgery Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Maryland Ambulatory Surgery Center LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Tristan Shockley, MD

Physical Medicine and Rehabilitation

NPI 1932242542

14205 PARK CENTER DR SUITE 204
Laurel, MD 20707

(240) 786-1001

✔ PECOS6.9 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 21D2218974

Maryland Ambulatory Surgery Center · Lanham, MD

Active · expires Mar 31, 2027

CLIA Number21D2218974

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateApril 1, 2025

Certificate Expiration DateMarch 31, 2027

Laboratory DirectorDr. Tristan J. Shockley

Laboratory Phone(301) 850-4401

Laboratory LocationMaryland Ambulatory Surgery Center7501 Forbes Blvd #103, Lanham, MD 20706

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims

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 of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level 64483

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

34 services26 patients

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 Maryland Ambulatory Surgery Center LLC's NPI number?

The NPI number for Maryland Ambulatory Surgery Center LLC is 1487280871. It was assigned to this organization in the NPPES registry on March 17, 2020.

Where is Maryland Ambulatory Surgery Center LLC located?

Maryland Ambulatory Surgery Center LLC is located at 7501 Forbes Blvd Ste 103, Lanham, MD 20706. The listed phone number is (202) 498-1125.

What is Maryland Ambulatory Surgery Center LLC's specialty?

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

Is Maryland Ambulatory Surgery Center LLC enrolled in Medicare?

Yes. Maryland Ambulatory Surgery Center LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Maryland Ambulatory Surgery Center LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Physical Medicine and Rehabilitation) reassigns their Medicare billing to Maryland Ambulatory Surgery Center LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Maryland Ambulatory Surgery Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2218974) is associated with this NPI, valid through March 31, 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 Maryland Ambulatory Surgery Center LLC was last updated on June 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.