NPIMap

Organization Active NPI

Lucis Consulting LLC

  • Gynecologic Oncology Physician
  • Clinton, MD
National Provider Identifier
1467833756
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
Legal business name
LUCIS CONSULTING LLC
Practice address
9131 Piscataway Rd Ste 540
Clinton, MD 20735-2562
Phone
(301) 997-8067
Fax
(240) 318-3029
NPI assigned
Jun 12, 2015
Last updated
May 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Authorized official

Name
Okechukwu Ibeanu, MDNPI 1538182571
Title
Physician / Owner
Phone
(301) 997-8067

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X NU Primary

Addresses

Primary practice location

9131 Piscataway Rd Ste 540
Clinton, MD 20735-2562

Mailing address

805 Jennings Mill Dr
Bowie, MD 20721-6214

Other practice location 1

805 Jennings Mill Dr
Bowie, MD 20721-6214
Phone (301) 997-8067

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150922000089 DC Part B Supplier - Clinic/Group Practice 1254648363 Receives reassigned benefits from 1 practitioner
Practice locations: Clinton, MD
O20180611001655 MD Part B Supplier - Clinic/Group Practice 1254648363 Receives reassigned benefits from 1 practitioner
Practice locations: Glen Burnie, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1434067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1467833756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 JENNINGS MILL DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207216214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9131 PISCATAWAY RD STE 540",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207352562",
            "telephone_number": "301-997-8067",
            "fax_number": "240-318-3029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "805 Jennings Mill Dr",
            "address_purpose": "LOCATION",
            "city": "Bowie",
            "state": "MD",
            "postal_code": "207216214",
            "country_code": "US",
            "telephone_number": "301-997-8067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUCIS CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-12",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A",
        "authorized_official_last_name": "IBEANU",
        "authorized_official_first_name": "OKECHUKWU",
        "authorized_official_title_or_position": "PHYSICIAN / OWNER",
        "authorized_official_telephone_number": "301-997-8067",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.