Individual provider Active NPI

Tangela M Gaines, PA-C

  • Medical Physician Assistant
  • Annapolis, MD
National Provider Identifier
1598884207
Registry record updated Dec 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C03729 Issued in MD
Practice address
2001 Medical Parkway
Acute Care Pavilion
Annapolis, MD 21401-3280
Phone
(443) 481-6482
Fax
(443) 481-6515
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C03729 MD Primary

Addresses

Primary practice location

2001 Medical Parkway
Acute Care Pavilion
Annapolis, MD 21401-3280

Mailing address

PO Box 12622
Belfast, ME 04915-4017
Phone (443) 481-6569

Other identifiers 3

IdentifierTypeStateIssuer
607156014OtherFEDERAL BLACK LUNG
607156012OtherUS DEPT. OF LABOR
607156012OtherDEPT OF LABOR (FEDERAL)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081015000454 MD Practitioner - Physician Assistant 0042319303 Reassigns benefits to 1 organization
I20111103000182 DC Practitioner - Physician Assistant 0042319303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

4175 N Hanson Court
201 Luminis Health Breast Center of Bowie
Bowie, MD 20716-3181
Phone (443) 481-5300

4175 N Hanson CT
Bowie, MD 20716-3181

8118 Good Luck Rd
Lanham, MD 20706-3574
Phone (301) 552-8118

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.45 of 100Reported as group
Quality
67.28
Promoting interoperability
98
Improvement activities
40
Cost
72.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C03729MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC CurrentSince Jul 6, 2010 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Jul 6, 2010 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Jun 11, 2023 Accepting new patients
Anne Arundel Medical Center Inc Past Accepting new patients
Maryland Inpatient Care Specialists LLC Past Accepting new patients
Anne Arundel Medical Center Inc Past Accepting new patients
Anne Arundel Medical Center Inc Past Accepting new patients

Locations

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

2000 Medical Pkwy
Ste 409
Annapolis, MD 21401
Phone (443) 481-5136

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

4175 N Hanson Ct
Ste 201
Bowie, MD 20716
Phone (443) 481-1199

Organizations & group practices 9

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387843200000",
    "number": "1598884207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12622",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154017",
            "telephone_number": "443-481-6569",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MEDICAL PARKWAY",
            "address_2": "ACUTE CARE PAVILION",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013280",
            "telephone_number": "443-481-6482",
            "fax_number": "443-481-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINES",
        "first_name": "TANGELA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2013-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C03729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "607156014",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT. OF LABOR",
            "identifier": "607156012",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR (FEDERAL)",
            "identifier": "607156012",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.