Individual provider Active NPI

James D Luciuk, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1639117591
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R107868 Issued in MD
Practice address
21 W 25TH St
Baltimore, MD 21218
Phone
(410) 366-1717
Fax
(410) 889-4176
NPI assigned
Jun 3, 2006
Last updated
Jun 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R107868 MD Primary
Primary Care Nurse Practitioner 363LP2300X R107868 MD

Addresses

Primary practice location

21 W 25TH St
Baltimore, MD 21218

Mailing address

201 N Charles St Ste 200
Baltimore, MD 21201-4166
Phone (410) 576-9191

Other practice location 1

901 Dulaney Valley Rd
Suite 129
Towson, MD 21204-2600
Phone (410) 832-2729

Other practice location 2

201 N Charles St Ste 200
Baltimore, MD 21201-4166
Phone (410) 576-9191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medop Behavioral Health Associates of Maryland PC Psychiatric/Mental Health PastSince Nov 1, 2006 Accepting new patients
Psychogeriatric Services LLC Past Accepting new patients

Organizations & group practices 2

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1639117591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N CHARLES ST STE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014166",
            "telephone_number": "410-576-9191",
            "fax_number": "410-576-9257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 W 25TH ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21218",
            "telephone_number": "410-366-1717",
            "fax_number": "410-889-4176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Dulaney Valley Rd",
            "address_2": "Suite 129",
            "address_purpose": "LOCATION",
            "city": "Towson",
            "state": "MD",
            "postal_code": "212042600",
            "country_code": "US",
            "telephone_number": "410-832-2729",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 N Charles St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212014166",
            "country_code": "US",
            "telephone_number": "410-576-9191",
            "fax_number": "410-576-9257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCIUK",
        "first_name": "JAMES",
        "middle_name": "D",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R107868",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R107868",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.