NPIMap

Organization Active NPI

Luminis Health Medical Group, LLC

Doing business as Anne Arundel Medical Group- Pasadena Primary Care

  • Family Medicine Physician
  • Pasadena, MD
National Provider Identifier
1063837490
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D27388 Issued in MD
Legal business name
LUMINIS HEALTH MEDICAL GROUP, LLC
Doing business as
Anne Arundel Medical Group- Pasadena Primary Care
Practice address
8109 Ritchie Hwy
Suite 100
Pasadena, MD 21122-6917
Phone
(443) 270-8600
Fax
(443) 270-8990
NPI assigned
Feb 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Melissa Rapattoni
Title
Ao
Phone
(443) 481-5136

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X D27388 MD Primary

Addresses

Primary practice location

8109 Ritchie Hwy
Suite 100
Pasadena, MD 21122-6917

Mailing address

201 Defense Hwy
Annapolis, MD 21401-8943
Phone (443) 481-1000

Other names 1

  • Anne Arundel Medical Group- Pasadena Primary Care 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

Locations

201 Defense Hwy
Annapolis, MD 21401

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1392940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1063837490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 DEFENSE HWY",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214018943",
            "telephone_number": "443-481-1000",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8109 RITCHIE HWY",
            "address_2": "SUITE 100",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211226917",
            "telephone_number": "443-270-8600",
            "fax_number": "443-270-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINIS HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-21",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "RAPATTONI",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "443-481-5136"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D27388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anne Arundel Medical Group- Pasadena Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Anne Arundel Medical Group- Pasadena Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pasadena, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.