NPIMap

Organization Active NPI

Vein and Vascular Institute of Central Maryland

  • Vascular Surgery Physician
  • Lutherville, MD
National Provider Identifier
1033683339
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
VEIN AND VASCULAR INSTITUTE OF CENTRAL MARYLAND
Practice address
1300 York Rd Ste 200
Lutherville, MD 21093-6090
Phone
(410) 371-1430
NPI assigned
Jan 20, 2019
Last updated
Mar 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Authorized official

Name
Dr. Paul Lucas, MDNPI 1528036589
Title
Medical Director
Phone
(667) 206-2343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X NU Primary

Addresses

Primary practice location

1300 York Rd Ste 200
Lutherville, MD 21093-6090

Mailing address

1300 York Rd BLG C, Suite 200
Lutherville, MD 21093-6090
Phone (667) 206-2343

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190719000483 MD Part B Supplier - Clinic/Group Practice 9436485042 Receives reassigned benefits from 4 practitioners
Practice locations: Lutherville Timonium, MD

National Provider Directory

National Provider Directory

Locations

1300 York Rd
Bldg C
Luthvle Timon, MD 21093
Phone (410) 371-1430

Practitioners & affiliated clinicians

Practitioners 4

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": "1547942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583366400000",
    "number": "1033683339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 YORK RD BLG C, SUITE 200",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936090",
            "telephone_number": "667-206-2343",
            "fax_number": "443-275-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 YORK RD STE 200",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936090",
            "telephone_number": "410-371-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEIN AND VASCULAR INSTITUTE OF CENTRAL MARYLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-20",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "667-206-2343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.