Individual provider Active NPI

Daina B Pack, M.D.

  • Diagnostic Radiology Physician
  • Annapolis, MD
National Provider Identifier
1285636092
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
D0045676 Issued in MD
Practice address
2002 Medical Pkwy
Suite 235
Annapolis, MD 21401-3046
Phone
(410) 266-2770
Fax
(410) 841-6251
NPI assigned
Aug 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X D0045676 MD Primary

Addresses

Primary practice location

2002 Medical Pkwy
Suite 235
Annapolis, MD 21401-3046

Mailing address

2002 Medical Pkwy
Suite 235
Annapolis, MD 21401-3046
Phone (410) 266-2770

Other identifiers 6

IdentifierTypeStateIssuer
A11OtherMDAAD PG COUNTY
10690011OtherMDBCBS
2622593OtherMDAETNA HMO/POS
735COtherMDAAD SHIPLEYS
277NOtherMDAAD AA COUNTY
8317071OtherMDAETNA PPO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20041229000151 DC Practitioner - Diagnostic Radiology 7517925159 Reassigns benefits to 2 organizations
I20050324000261 MD Practitioner - Diagnostic Radiology 7517925159 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Luminis Health Imaging, Inc.Group PAC ID 8729054598, 22 clinicians
Brown, Croft, Frazier, PAGroup PAC ID 9537101746, 28 clinicians

Practice addresses (Care Compare)

2000 Medical Pkwy
Suite 202
Annapolis, MD 21401-3744
Phone (443) 481-5660

2001 Medical Pkwy
Annapolis, MD 21401-3773
Phone (410) 266-2770

4175 N Hanson CT
Bowie, MD 20716-3179
Phone (443) 481-3260

8118 Good Luck Rd
Lanham, MD 20706-3574
Phone (410) 266-2770

Hospital & facility affiliations

  • Luminis Health Anne Arundel Medical Center, Inc Hospital, Annapolis, MD, CCN 210023
  • Luminis Health Doctors Community Medical Ctr, Inc Hospital, Lanham, MD, CCN 210051

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Imaging, Inc. Diagnostic Radiology CurrentSince Jul 1, 1995 Accepting new patients
Luminis Health Imaging, Inc. Diagnostic Radiology CurrentSince Jul 1, 1995 Accepting new patients
Brown, Croft, Frazier, PA Diagnostic Radiology CurrentSince Jul 1, 1995 Accepting new patients
Shipley'S Imaging, LLC Diagnostic Radiology Past Accepting new patients
Orthopaedic and Sports Medicine Center LLC Past Accepting new patients
Orthopaedic and Sports Medicine Center LLC Past Accepting new patients
David L Bloom PA Diagnostic Radiology Past Accepting new patients
Nighttime Radiology LLC Diagnostic Radiology Past Accepting new patients

Locations

2000 Medical Pkwy
Ste 202
Annapolis, MD 21401
Phone (443) 481-4915

2002 Medical Pkwy
Annapolis, MD 21401
Phone (443) 481-4915

108 Forbes St
Annapolis, MD 21401
Phone (410) 729-4878

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

2002 Medical Pkwy
Ste 235
Annapolis, MD 21401

4175 N Hanson Ct
Bowie, MD 20716
Phone (301) 464-0798

2108 Red Apple Plz
Chester, MD 21619
Phone (410) 643-6205

8118 Good Luck Rd
Lanham Seabrook, MD 20706
Phone (301) 552-8608

8601 Veterans Hwy
Ste 100
Millersville, MD 21108
Phone (410) 729-4450

Organizations & group practices 8

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 3

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194912000000",
    "number": "1285636092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY",
            "address_2": "SUITE 235",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013046",
            "telephone_number": "410-266-2770",
            "fax_number": "410-841-6251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY",
            "address_2": "SUITE 235",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013046",
            "telephone_number": "410-266-2770",
            "fax_number": "410-841-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "DAINA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2007-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0045676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAD PG COUNTY",
            "identifier": "A11",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "10690011",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO/POS",
            "identifier": "2622593",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAD SHIPLEYS",
            "identifier": "735C",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAD AA COUNTY",
            "identifier": "277N",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "8317071",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.