NPIMap

Organization Active NPI

Luminis Health Medical Group, LLC

Doing business as Annapolis Thoracic Surgery Associates

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Chester, MD
National Provider Identifier
1295063923
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
LUMINIS HEALTH MEDICAL GROUP, LLC
Doing business as
Annapolis Thoracic Surgery Associates
Practice address
1630 Main St
Suite 213
Chester, MD 21619-2791
Phone
(443) 481-3300
Fax
(443) 481-3315
NPI assigned
Nov 18, 2009
Last updated
Feb 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Authorized official

Name
Stephen Clarke
Title
Vice President
Phone
(443) 481-6476

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X NU Primary

Addresses

Primary practice location

1630 Main St
Suite 213
Chester, MD 21619-2791

Mailing address

PO Box 412752
Boston, MA 02241-4017
Phone (443) 481-6538

Other practice location 1

2003 Medical Pkwy Ste 301
Annapolis, MD 21401-3081
Phone (443) 481-3717

Other names 1

  • Annapolis Thoracic Surgery Associates 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
Tax ID family
Luminis Health Primary Care224 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1630 Main St
Ste 204
Chester, MD 21619
Phone (410) 224-4887

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677024000000",
    "number": "1295063923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412752",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022414017",
            "telephone_number": "443-481-6538",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 MAIN ST",
            "address_2": "SUITE 213",
            "city": "CHESTER",
            "state": "MD",
            "postal_code": "216192791",
            "telephone_number": "443-481-3300",
            "fax_number": "443-481-3315"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2003 Medical Pkwy Ste 301",
            "address_purpose": "LOCATION",
            "city": "Annapolis",
            "state": "MD",
            "postal_code": "214013081",
            "country_code": "US",
            "telephone_number": "443-481-3717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUMINIS HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-18",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "443-481-6476"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Annapolis Thoracic Surgery Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Annapolis Thoracic Surgery Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chester, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.