NPIMap

Organization Active NPI

Luminis Health Medical Group, LLC

  • Surgery Physician
  • Easton, MD
National Provider Identifier
1639736200
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
LUMINIS HEALTH MEDICAL GROUP, LLC
Practice address
28438 Marlboro Ave
Easton, MD 21601-2732
Phone
(410) 822-2440
NPI assigned
May 20, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Authorized official

Name
Peter Odenwald
Title
Vice President
Phone
(443) 481-6415

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

28438 Marlboro Ave
Easton, MD 21601-2732

Mailing address

PO Box 12622
Belfast, ME 04915-4017

Other names 1

  • The Breast Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Anne Arundel Phys Group LLC221 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1639736200",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28438 MARLBORO AVE",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216012732",
            "telephone_number": "410-822-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINIS HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-20",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "ODENWALD",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "443-481-6415"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Breast Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Breast Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Easton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.