Individual provider Active NPI

Luke Kenneth Dombert, MD

  • Surgery Physician
  • Baltimore, MD
National Provider Identifier
1215431671
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
D96258 Issued in MD
Practice address
600 N Wolfe St
Baltimore, MD 21287-0005
Phone
(410) 955-9441
NPI assigned
Mar 21, 2018
Last updated
Mar 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MT215189 PA
Surgery Physician 208600000X D96258 MD Primary

Addresses

Primary practice location

600 N Wolfe St
Baltimore, MD 21287-0005

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004

Other practice location 1

1 Guthrie Sq
Sayre, PA 18840-1625
Phone (570) 887-5858

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ldombert49974@direct-guthrie.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230405002637 MD Practitioner - General Surgery 9537416847 Reassigns benefits to 1 organization
I20240829000787 MA Practitioner - General Surgery 9537416847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
State University of Ny Upstate Medical University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Surgical Associates, PCGroup PAC ID 8123263837, 9 clinicians

Practice addresses (Care Compare)

275 Varnum Ave
Suite 203
Lowell, MA 01854-2109
Phone (978) 458-4300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D96258MDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Jan 1, 2023 Accepting new patients
Riverside Surgical Associates, PC Surgery CurrentSince Sep 1, 2024 Accepting new patients
Johns Hopkins University Surgery CurrentSince Jan 1, 2023 Accepting new patients
Johns Hopkins University Current Accepting new patients
The Lowell General Hospital Past Accepting new patients

Locations

1 Hospital Dr
Lowell, MA 01852
Phone (978) 687-0156

275 Varnum Ave
Ste 203
Lowell, MA 01854
Phone (978) 458-4300

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

20 Research Pl
North Chelmsford, MA 01863
Phone (978) 788-7200

2527 Cranberry Hwy
Wareham, MA 02571
Phone (508) 295-5556

600 N Wolfe St
Baltimore, MD 21287

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d04f75c7-2a62-4686-b520-7bf0635f38f0/
  • Direct secure messaging: ldombert127231@tuftsmedicine.direct-ci.com
  • Direct secure messaging: ldombert49974@direct-guthrie.org

Organizations & group practices 5

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

Hospital & facility affiliations 1

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": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1215431671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-955-9441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Guthrie Sq",
            "address_purpose": "LOCATION",
            "city": "Sayre",
            "state": "PA",
            "postal_code": "188401625",
            "country_code": "US",
            "telephone_number": "570-887-5858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMBERT",
        "first_name": "LUKE",
        "middle_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT215189",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D96258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ldombert49974@direct-guthrie.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1 Guthrie Sq",
            "city": "Sayre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "188401625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.