Individual provider Active NPI

John D Luck, M.D

  • Surgery Physician
  • Randallstown, MD
National Provider Identifier
1619332475
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
D90135 Issued in MD
Practice address
5401 Old Court Rd Dept of
Randallstown, MD 21133-5103
Phone
(410) 521-2200
Fax
(410) 496-7530
NPI assigned
Dec 22, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 77877 MN
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X D90135 MD Primary

Addresses

Primary practice location

5401 Old Court Rd Dept of
Randallstown, MD 21133-5103

Mailing address

303 E Nicollet Blvd
Suite 330
Burnsville, MN 55337
Phone (952) 435-0177

Other practice location 1

600 N Wolfe St
Baltimore, MD 21287-0005
Phone (410) 955-5000

Other names 1

  • J.D. Luck Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20201020000952 MD Practitioner - General Surgery 5496003824 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77877MNMDPlastic Surgery Physician
D90135MDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Paul Place Specialists, Inc. CurrentSince Oct 15, 2020 Accepting new patients
Northwest Hospital Center, Inc. CurrentSince Oct 1, 2020 Accepting new patients
St Paul Place Specialists Inc CurrentSince Oct 15, 2020 Accepting new patients
St. Paul Place Specialists, Inc. Current Accepting new patients
Northwest Hospital Center, Inc Plastic Surgery CurrentSince Oct 1, 2020 Accepting new patients
Gryskiewicz Twin Cities Cosmetic Surgery PastSince Aug 10, 2025 Accepting new patients

Locations

301 Saint Paul St
Baltimore, MD 21202
Phone (410) 385-4930

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1619332475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E NICOLLET BLVD",
            "address_2": "SUITE 330",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "55337",
            "telephone_number": "952-435-0177",
            "fax_number": "952-435-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 OLD COURT RD DEPT OF",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335103",
            "telephone_number": "410-521-2200",
            "fax_number": "410-496-7530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N Wolfe St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870005",
            "country_code": "US",
            "telephone_number": "410-955-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCK",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-22",
        "last_updated": "2025-08-05",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MN",
            "license": "77877",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D90135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J.D.",
            "last_name": "LUCK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Randallstown, MD

Sources for this page

Verify at the official NPI Registry.