Individual provider Active NPI

Lyn Nguyen Dea, D.O.

  • Family Medicine Physician
  • Annapolis, MD
National Provider Identifier
1063413599
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H0058097 Issued in MD
Practice address
129 Lubrano Dr
Suite 100
Annapolis, MD 21401-7566
Phone
(410) 266-5852
Fax
(410) 266-5095
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H0058097 MD Primary

Addresses

Primary practice location

129 Lubrano Dr
Suite 100
Annapolis, MD 21401-7566

Mailing address

7580 Buckingham Blvd Ste 220
Hanover, MD 21076-3210
Phone (410) 729-5100

Other identifiers 11

IdentifierTypeStateIssuer
0073009OtherMDCIGNA PIN NUMBER
7744382OtherMDAETNA FEE FOR SERVICE
2981630OtherMDAETNA CAPITATED
8110689OtherMDMAMSI PRIMARY CARE
80184145OtherMDRAILROAD MEDICARE
P15500OtherMDCAREFIRST MPOS
2110689OtherMDMAMSI SPECIALIST
7605-0050OtherMDCAREFIRST BLUECHOICE
615698-01OtherMDCAREFIRST RENDERING
014378OtherMDJHHC PROVIDER NUMBER
404150000MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100621000581 MD Practitioner - Family Practice 8729119623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maryland Primary Care Physicians, LLCGroup PAC ID 8729981832, 101 clinicians

Practice addresses (Care Compare)

129 Lubrano Dr
Suite 100
Annapolis, MD 21401-7566
Phone (410) 266-5852

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Primary Care Physicians, LLC CurrentSince Jan 14, 2002 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

129 Lubrano Dr
Ste 100
Annapolis, MD 21401
Phone (410) 266-5852

1509 Ritchie Hwy
Arnold, MD 21012
Phone (410) 757-1600

7580 Buckingham Blvd
Ste 220
Hanover, MD 21076
Phone (410) 729-5100

1111 Benfield Blvd
Ste 200
Millersville, MD 21108
Phone (410) 729-5100

Interoperability endpoints

  • Direct secure messaging: ldea42493@direct.umm.edu

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1063413599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7580 BUCKINGHAM BLVD STE 220",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210763210",
            "telephone_number": "410-729-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 LUBRANO DR",
            "address_2": "SUITE 100",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017566",
            "telephone_number": "410-266-5852",
            "fax_number": "410-266-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEA",
        "first_name": "LYN",
        "middle_name": "NGUYEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "H0058097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN NUMBER",
            "identifier": "0073009",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA FEE FOR SERVICE",
            "identifier": "7744382",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA CAPITATED",
            "identifier": "2981630",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI PRIMARY CARE",
            "identifier": "8110689",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "80184145",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MPOS",
            "identifier": "P15500",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI SPECIALIST",
            "identifier": "2110689",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUECHOICE",
            "identifier": "7605-0050",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST RENDERING",
            "identifier": "615698-01",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JHHC PROVIDER NUMBER",
            "identifier": "014378",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404150000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.