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NEWBRIDGE SURGERY CENTER AT WALDORF
NPI 1710112669
Clinic/Center - Ambulatory Surgical in Waldorf, MD

Active since May 21, 2009CLIA 21D1101649 · Waiver
3581 OLD WASHINGTON ROAD, SUITE G, WALDORF, MD 20602(301) 638-4400(301) 638-2200 Get Directions Write a Review

NPPES record last updated: April 4, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Newbridge Surgery Center At Waldorf NPPES

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

NEWBRIDGE SURGERY CENTER AT WALDORF (NPI 1710112669) is a healthcare organization registered as an ambulatory surgical in Waldorf, Maryland and active in the NPI registry since May 2009. The organization holds a CLIA Waiver certificate valid through June 30, 2027 and lists Mruthyunjaya Gonchigar, Owner/physician, as its authorized official.

NPPES Registry Identity

NPI1710112669
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameNEWBRIDGE SURGERY CENTER AT WALDORF
Location Address3581 OLD WASHINGTON ROAD, SUITE GWaldorf, MD 20602
Mailing Address196 Thomas Johnson Dr, Suite 215Frederick, MD 21702-4397 · (301) 668-9988 · Fax (301) 668-9977
Phone(301) 638-4400
Fax(301) 638-2200
Organization SubpartNo
Authorized OfficialMruthyunjaya GonchigarOwner/physician · (301) 668-9988
Enumeration DateMay 21, 2009
Last NPPES UpdateApril 4, 2025
NPPES CertifiedApril 4, 2025
✔ NPI 1710112669 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
3581 OLD WASHINGTON ROAD, Waldorf, MD 20602
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Newbridge Surgery Center At Waldorf is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateMarylandEnrollment IDO20121015000065Non-DME Part B · Ambulatory Surgical CenterDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Newbridge Surgery Center At Waldorf, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Shengyun Li, MD, PHD
Neurology
NPI 1265995351
501 N FREDERICK AVE STE 302
Gaithersburg, MD 20877
(240) 220-6600
✔ PECOS✔ Accepts Medicare39 mi
Ashraf Sabahat, MD
Pain Management
NPI 1386654051
220 STEUBEN ST
Montour Falls, NY 14865
(607) 535-8626
✔ PECOS✔ Accepts Medicare258 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 21D1101649

Newbridge Surgery Center At Waldorf · Waldorf, MD
Active · expires Jun 30, 2027
CLIA Number21D1101649
Laboratory TypePhysician Office
Certificate Effective DateJuly 1, 2025
Certificate Expiration DateJune 30, 2027
Laboratory DirectorMruthyunjaya Gonchigar MD
Laboratory Phone(301) 638-4400
Laboratory LocationNewbridge Surgery Center At Waldorf3581 Old Washington Road Suite G, Waldorf, MD 20602
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 8

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 lower or sacral spine facet joint using imaging guidance, single level 64493
This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.
147 services55 patients
Injection of substance into lower spine canal using imaging guidance 62323
This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.
81 services64 patients
Injection of substance into middle or upper spine canal using imaging guidance 62321
This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.
38 services27 patients
Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint 64635
This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.
38 services27 patients
Injection of upper or middle spine facet joint using imaging guidance, single level 64490
This procedure involves injecting medication into a joint in your upper or middle spine. It's performed under imaging guidance for precision. The aim is to reduce inflammation and pain. It's a single-level process, meaning one joint is treated at a time.
35 services14 patients
Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography G0260
This procedure involves injecting medicine into the sacroiliac joint, located in the lower back. The aim is to reduce inflammation and pain. Anesthetic is used for immediate pain relief, while a steroid helps decrease inflammation over time. Arthrography, a type of imaging, may be used for precision.
27 services16 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 Newbridge Surgery Center At Waldorf's NPI number?

The NPI number for Newbridge Surgery Center At Waldorf is 1710112669. It was assigned to this organization in the NPPES registry on May 21, 2009.

Where is Newbridge Surgery Center At Waldorf located?

Newbridge Surgery Center At Waldorf is located at 3581 Old Washington Road Suite G, Waldorf, MD 20602. The listed phone number is (301) 638-4400.

What is Newbridge Surgery Center At Waldorf's specialty?

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

Is Newbridge Surgery Center At Waldorf enrolled in Medicare?

Yes. Newbridge Surgery Center At Waldorf is registered in the Medicare PECOS enrollment system.

When is Newbridge Surgery Center At Waldorf's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Maryland, Ambulatory Surgical Center) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Newbridge Surgery Center At Waldorf?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Newbridge Surgery Center At Waldorf, in Neurology and Pain Management. 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 Newbridge Surgery Center At Waldorf hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D1101649) is associated with this NPI, valid through June 30, 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 Newbridge Surgery Center At Waldorf was last updated on April 4, 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.