COLLEGE PARK SURGERY CENTER LLC NPI 1962711614

NPI Information

  • NPI: 1962711614
  • Provider Name: COLLEGE PARK SURGERY CENTER, LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • CLIA Number: 21D2136938
  • Address: 12200 ANNAPOLIS RD
    SUITE 220
    GLENN DALE, MD
    ZIP 20769
  • Phone: (301) 699-2292

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NPI Details

COLLEGE PARK SURGERY CENTER, LLC is an ambulatory surgical clinic center in Glenn Dale, MD. COLLEGE PARK SURGERY CENTER, LLC NPI is 1962711614. The provider is registered as an organization entity type.

The provider's business location address is:

12200 ANNAPOLIS RD
SUITE 220
GLENN DALE, MD
ZIP 20769-182
Phone: (301) 699-2292
Fax: (301) 699-2293

The provider's authorized official is Alpha T. Banks .
The authorized official title is Medical Director and has the following contact phone number (301) 699-2292.

The CLIA number assigned to this NPI record is 21D2136938 - physician office with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Diagnostic exam of large bowel using a flexible endoscope (HCPCS:45378)
  • Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk (HCPCS:G0121)

The enumeration date for this NPI number is 9/29/2010 and was last updated on 9/29/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory SurgicalMD18563DISTRICT OF COLUMBIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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