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Luminis Health Medical Group, LLC

Organization Active NPI Internal Medicine Physician · Severna Park, MD

NPI 1154594513 · NPPES record last updated May 24, 2021

Key facts

NPI
1154594513
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
LUMINIS HEALTH MEDICAL GROUP, LLC
Practice address
821 W Benfield Rd
Suite 8
Severna Park, MD 21146-2220
Phone
(410) 729-0660
Fax
(410) 729-0599
NPI assigned
Apr 8, 2008
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 12

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MD

Medicare enrollment records

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

Tax ID family
Anne Arundel Phys Group LLC (221 organizations share this tax ID)

Locations

175 Harry S Truman Pkwy
Annapolis, MD 21401
Phone (410) 573-9000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207R00000X Yes

Addresses

Primary practice location

821 W Benfield Rd
Suite 8
Severna Park, MD 21146-2220

Mailing address

PO Box 12622
Belfast, ME 04915-4017
Phone (443) 481-6460

Other identifiers

IdentifierTypeStateIssuer
H651OtherBCBS
407175120MedicaidMD
FNB1SMOtherBCBS

Other names

  • Sharon M Messics MD Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 24, 2021.

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1154594513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12622",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154017",
            "telephone_number": "443-481-6460",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 W BENFIELD RD",
            "address_2": "SUITE 8",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462220",
            "telephone_number": "410-729-0660",
            "fax_number": "410-729-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINIS HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "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": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "H651",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "407175120",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "FNB1SM",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sharon M Messics MD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sharon M Messics MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Severna Park, MD

All providers in Severna Park, MD · Internal Medicine Physician in Maryland

Sources for this page

Verify at the official NPI Registry.