Organization Active NPI

Lumos Advanced Treatment Center PC

  • Psychiatry Physician
  • San Jose, CA
National Provider Identifier
1568353449
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
LUMOS ADVANCED TREATMENT CENTER PC
Practice address
2516 Samaritan Dr Ste D
San Jose, CA 95124-4108
Phone
(669) 271-8717
NPI assigned
Jul 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Authorized official

Name
Dr. Sarbani Maitra, MDNPI 1134360647
Title
Owner
Phone
(669) 271-8717

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

2516 Samaritan Dr Ste D
San Jose, CA 95124-4108

Mailing address

16320 Alexander CT
Monte Sereno, CA 95030-5204
Phone (669) 271-8717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251006003634 CA Part B Supplier - Clinic/Group Practice 9133626369 Receives reassigned benefits from 1 practitioner
Practice locations: San Jose, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1752105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770681600000",
    "number": "1568353449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16320 ALEXANDER CT",
            "city": "MONTE SERENO",
            "state": "CA",
            "postal_code": "950305204",
            "telephone_number": "669-271-8717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 SAMARITAN DR STE D",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244108",
            "telephone_number": "669-271-8717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMOS ADVANCED TREATMENT CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-10",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A",
        "authorized_official_last_name": "MAITRA",
        "authorized_official_first_name": "SARBANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "669-271-8717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; 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.