NPIMap

Organization Active NPI

Luminis Health Medical Group, LLC

Doing business as Chesapeake Surgical Assoc., L.L.C.

  • Surgery Physician
  • Annapolis, MD
National Provider Identifier
1003883216
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
LUMINIS HEALTH MEDICAL GROUP, LLC
Doing business as
Chesapeake Surgical Assoc., L.L.C.
Practice address
2009 Tidewater Colony Way
#2A
Annapolis, MD 21401-2127
Phone
(410) 571-9499
Fax
(410) 571-6486
NPI assigned
Mar 7, 2006
Last updated
May 21, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ANNE ARUNDEL PHYSICIAN GROUP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Stephen Clarke
Title
Vice President
Phone
(443) 481-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

2009 Tidewater Colony Way
#2A
Annapolis, MD 21401-2127

Mailing address

PO Box 64421
Baltimore, MD 21264-4421
Phone (443) 481-6576

Other names 1

  • CHESAPEAKE SURGICAL ASSOC., L.L.C. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050317000146 MD Part B Supplier - Clinic/Group Practice 2860447315 Receives reassigned benefits from 897 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
Luminis Health Primary Care Ginger Cove

Locations

2635 Riva Rd
Annapolis, MD 21401
Phone (410) 573-9000

202 Coursevall Dr
Ste 101
Centreville, MD 21617
Phone (410) 758-3303

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621555200000",
    "number": "1003883216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64421",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644421",
            "telephone_number": "443-481-6576",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 TIDEWATER COLONY WAY",
            "address_2": "#2A",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214012127",
            "telephone_number": "410-571-9499",
            "fax_number": "410-571-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINIS HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANNE ARUNDEL PHYSICIAN GROUP, LLC",
        "enumeration_date": "2006-03-07",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "443-481-1000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHESAPEAKE SURGICAL ASSOC., L.L.C.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHESAPEAKE SURGICAL ASSOC., L.L.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.