SURGERY CENTER OF POTOMAC LLC
NPI 1710079470
Clinic/Center - Ambulatory Surgical in Rockville, MD

NPI Status: Active since September 29, 2006

Contact Information

3203 TOWER OAKS BLVD
#100
ROCKVILLE, MD
ZIP 20852
Phone: (240) 747-5631
Fax: (301) 754-2503

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • CLIA Number: 21D1053162
  • CLIA Cert. Type: Community Clinic
  • CLIA Exp. Date: 04-16-2026

About SURGERY CENTER OF POTOMAC LLC

This page provides the complete NPI Profile along with additional information for Surgery Center Of Potomac Llc, a provider established in Rockville, Maryland operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1710079470 assigned on September 2006. The practitioner's primary taxonomy code is 261QA1903X with license number A1404 (MD). The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Dr. Adam Gaston Tattelbaum Md (Owner)

NPI
1710079470
Provider Name
SURGERY CENTER OF POTOMAC LLC
Entity Type
Organization
Location Address
3203 TOWER OAKS BLVD #100 ROCKVILLE, MD 20852
Location Phone
(240) 747-5631
Location Fax
(301) 754-2503
Mailing Address
3203 TOWER OAKS BLVD #100 ROCKVILLE, MD 20852
Mailing Phone
(240) 747-5631
Mailing Fax
(301) 754-2503
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-29-2006
Last Update Date
08-22-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities
License No.
A1404
License State
MD

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. ADAM GASTON TATTELBAUM MD

Authorized Official Title
OWNER
Authorized Official Phone
(240) 747-5631

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
21D1053162
Facility Type
Community Clinic
Certificate Effective Date
April 17, 2024
Certificate Expiration Date
April 16, 2026
Laboratory Director
BENNETT YANG
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Surgery Center Of Potomac Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1710079470
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
27200718414
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 2 + 0 + 0 + 7 + 1 + 8 + 4 + 1 + 4 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1710079470 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 7 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1982787594DR. BENNETT CHENG DAH YANG MD PC
Individual
Surgery (Plastic and Reconstructive Surgery)3203 TOWER OAKS BLVD #200
ROCKVILLE, MD 20852
(301) 656-6398
1134205057DR. FREDERICK HARVEY WATKINS IV MD
Individual
Plastic Surgery3203 TOWER OAKS BLVD #200
ROCKVILLE, MD 20852
(301) 656-6398
1619159910BENNETT C. YANG, M.D., P.C.
Organization
Specialist3203 TOWER OAKS BLVD STE 200
ROCKVILLE, MD 20852
(301) 656-6398
1073796454DONNELLY INC.
Organization
Nurse Anesthetist, Certified Registered3203 TOWER OAKS BLVD
ROCKVILLE, MD 20852
(240) 747-5650
1184871097BARRY J. COHEN, M.D., P.C.
Organization
Specialist3203 TOWER OAKS BLVD SUITE 200
ROCKVILLE, MD 20852
(301) 656-6398
1922328582BECKERMAN WOMEN'S HEALTH, LLC
Organization
Obstetrics & Gynecology (Gynecology)3203 TOWER OAKS BLVD SUITE 102
ROCKVILLE, MD 20852
(301) 230-1488
1578510202DR. ADAM G TATTELBAUM M.D.
Individual
Plastic Surgery3203 TOWER OAKS BLVD #200
ROCKVILLE, MD 20852
(301) 656-6398

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1710079470, enumerated in the NPI registry as an "organization" on September 29, 2006

The provider is located at 3203 Tower Oaks Blvd #100 Rockville, Md 20852 and the phone number is (240) 747-5631

This medical organization specializes in Clinic/Center with taxonomy code 261QA1903X with a focus in Ambulatory Surgical

The provider's CLIA number is 21D1053162 for a "community clinic" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on September 29, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.