Individual provider Active NPI

Maureen L O'Brien, PA

  • Surgical Physician Assistant
  • Annapolis, MD
National Provider Identifier
1740275148
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
C02505 Issued in MD
Practice address
2000 Medical Parkway
Suite 200
Annapolis, MD 21401-3744
Phone
(443) 481-5300
Fax
(443) 481-6705
NPI assigned
Sep 13, 2005
Last updated
Jan 15, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0002505 MD
Surgical Physician Assistant 363AS0400X C02505 MD Primary

Addresses

Primary practice location

2000 Medical Parkway
Suite 200
Annapolis, MD 21401-3744

Mailing address

PO Box 64294
Baltimore, MD 21264-4294
Phone (443) 481-6573

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
I20070717000666 MD Practitioner - Physician Assistant 3072613249 Reassigns benefits to 1 organization
I20100204000517 DC Practitioner - Physician Assistant 3072613249 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0002505MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC CurrentSince Sep 1, 2010 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Sep 1, 2010 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Sep 1, 2010 Accepting new patients

Locations

2000 Medical Pkwy
Ste 200
Annapolis, MD 21401
Phone (443) 481-3493

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

1630 Main St
Ste 213
Chester, MD 21619
Phone (443) 481-5300

Interoperability endpoints

  • Direct secure messaging: mobrien29408@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, 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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1740275148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64294",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644294",
            "telephone_number": "443-481-6573",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MEDICAL PARKWAY",
            "address_2": "SUITE 200",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013744",
            "telephone_number": "443-481-5300",
            "fax_number": "443-481-6705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "MAUREEN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0002505",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C02505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.