Individual provider Active NPI

Bruce David Preston, LCSW-C

  • Clinical Social Worker
  • Annapolis, MD
National Provider Identifier
1124676895
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09073 Issued in MD
Practice address
132 Holiday Court
Suite 209
Annapolis, MD 21401
Phone
(410) 224-4207
Fax
(410) 224-5659
NPI assigned
Aug 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 09073 MD Primary

Addresses

Primary practice location

132 Holiday Court
Suite 209
Annapolis, MD 21401

Mailing address

132 Holiday Court
Suite 209
Annapolis, MD 21401
Phone (410) 224-4207

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191205000527 MD Practitioner - Clinical Social Worker 4284067273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

175 Harry S Truman Pkwy
J. Kent McNew Family Medical Center
Annapolis, MD 21401-7573
Phone (443) 481-5400

Merit-based Incentive Payment System (MIPS)

Final score
81.45 of 100Reported as group
Quality
67.28
Promoting interoperability
98
Improvement activities
40
Cost
72.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09073MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC CurrentSince Oct 16, 2019 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Oct 16, 2019 Accepting new patients

Locations

175 Harry S Truman Pkwy
#J
Annapolis, MD 21401
Phone (443) 481-5400

132 Holiday Ct
Ste 209
Annapolis, MD 21401
Phone (410) 224-4207

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1124676895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 HOLIDAY COURT",
            "address_2": "SUITE 209",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21401",
            "telephone_number": "410-224-4207",
            "fax_number": "410-224-5659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 HOLIDAY COURT",
            "address_2": "SUITE 209",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21401",
            "telephone_number": "410-224-4207",
            "fax_number": "410-224-5659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "BRUCE",
        "middle_name": "DAVID",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "09073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.