Individual provider Active NPI

Jilian Nicholas, D.O.

  • Surgery Physician
  • Annapolis, MD
National Provider Identifier
1689054165
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
H91741 Issued in MD
Practice address
2000 Medical Pkwy Ste 600
Annapolis, MD 21401-3748
Phone
(443) 924-2900
NPI assigned
Jun 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X H91741 MD Primary

Addresses

Primary practice location

2000 Medical Pkwy Ste 600
Annapolis, MD 21401-3748

Mailing address

PO Box 412752 Apt G8
Boston, MA 02241-8800
Phone (443) 481-3356

Other practice location 1

1900 23rd St
Cuyahoga Falls, OH 44223-1404
Phone (330) 971-7271

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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210817003224 MD Practitioner - General Surgery 8325347230 Reassigns benefits to 1 organization
I20220816001048 DC Practitioner - General Surgery 8325347230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

2000 Medical Pkwy
Suite 409
Annapolis, MD 21401-3742

2000 Medical Pkwy
Suite 600
Annapolis, MD 21401-3748
Phone (443) 481-6699

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

8116 Good Luck Rd
Lanham, MD 20706-3508

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

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H91741MDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC CurrentSince Aug 25, 2022 Accepting new patients
Luminis Health Medical Group, LLC Surgery CurrentSince Aug 1, 2021 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Aug 1, 2021 Accepting new patients
Luminis Health Medical Group, LLC Surgery Current Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients

Locations

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

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

2000 Medical Pkwy
Ste 600
Annapolis, MD 21401
Phone (443) 481-6699

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

Interoperability endpoints

  • Direct secure messaging: jnicholas127216@direct.aahs.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1689054165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412752 APT G8",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022418800",
            "telephone_number": "443-481-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MEDICAL PKWY STE 600",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013748",
            "telephone_number": "443-924-2900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 23rd St",
            "address_purpose": "LOCATION",
            "city": "Cuyahoga Falls",
            "state": "OH",
            "postal_code": "442231404",
            "country_code": "US",
            "telephone_number": "330-971-7271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "JILIAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-01",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "H91741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.