NPIMap

Individual provider Active NPI

Brandon Luk, M.D.

  • Family Medicine Physician
  • Boston, MA
National Provider Identifier
1770862039
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD15094 Issued in RI
Practice address
332 Hanover St
Boston, MA 02113-1901
Phone
(617) 643-8000
NPI assigned
Aug 4, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD19880 HI
Family Medicine Physician 207Q00000X 2012026099 MO
Family Medicine Physician 207Q00000X 291101 MA
Surgery Physician 208600000X BP10039786 TX
Family Medicine Physician 207Q00000X MD15094 RI Primary

Addresses

Primary practice location

332 Hanover St
Boston, MA 02113-1901

Mailing address

332 Hanover St
Boston, MA 02113-1901
Phone (201) 562-2738

Other practice location 1

11 Friendship St
Newport, RI 02840-2209
Phone (401) 845-1281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150911001140 RI Practitioner - Family Practice 0749597508 Reassigns benefits to 4 organizations
I20221118000384 MA Practitioner - Internal Medicine 0749597508 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tulane University School of Medicine, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
North End Community Health Committee, Inc.Group PAC ID 8224043971, 56 clinicians
Hospital Medicine Associates LLCGroup PAC ID 9234156985, 208 clinicians

Practice addresses (Care Compare)

100 Kenyon Ave
Wakefield, RI 02879-4216
Phone (401) 782-8000

11 Friendship St
Newport, RI 02840-2209
Phone (401) 845-1472

15 Tufts St
Charlestown, MA 02129-2711
Phone (857) 238-1100

25 Wells St
Westerly, RI 02891-2922
Phone (401) 348-3325

332 Hanover Sreet
Boston, MA 02113-1901

332 Hanover St
Boston, MA 02113-1901
Phone (617) 643-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19880HIMDFamily Medicine Physician
2012026099MOMDFamily Medicine Physician
BP10039786TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Corporation Current Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Sep 1, 2024 Accepting new patients
North End Community Health Committee Inc CurrentSince Oct 3, 2022 Accepting new patients
Silver Spring Health Care Management, Inc. CurrentSince Aug 2, 2023 Accepting new patients
The General Hospital Corporation CurrentSince Oct 3, 2022 Accepting new patients
Hospital Medicine Associates LLC Family Medicine CurrentSince Jul 1, 2017 Accepting new patients
Silver Spring Health Care Management, Inc. Family Medicine Current Accepting new patients
Lifespan Physician Group, Inc. Surgery CurrentSince Sep 1, 2024 Accepting new patients
Northeast Medical Group, Inc. Surgery CurrentSince Jun 18, 2017 Accepting new patients
General Hospital Corp Current Accepting new patients
Women's Health of Westerly, LLC PastSince Jun 18, 2017 Accepting new patients

Locations

226 Mill Hill Ave
Ste 3
Bridgeport, CT 06610
Phone (203) 384-3394

332 Hanover St
Boston, MA 02113
Phone (617) 643-8000

55 Fruit St
Boston, MA 02114

11 Friendship St
Newport, RI 02840
Phone (401) 845-1110

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

70 Kenyon Ave
Unit 211
Wakefield, RI 02879
Phone (401) 789-8543

100 Kenyon Ave
Wakefield, RI 02879
Phone (401) 782-8000

45 Wells St
Ste 201
Westerly, RI 02891
Phone (401) 637-7200

25 Wells St
Westerly, RI 02891
Phone (401) 348-3325

45 Wells St
Ste 104
Westerly, RI 02891
Phone (401) 348-0008

45 Wells St
Westerly, RI 02891
Phone (401) 348-0008

45 East Ave
Westerly, RI 02891
Phone (401) 596-6000

Interoperability endpoints

  • Direct secure messaging: bluk226655@brownhealth.medalliesdirect.net
  • Direct secure messaging: bluk329556@direct.ynhh.org
  • Direct secure messaging: luk.brandon.mgh@direct.partners.masshiway.net

Organizations & group practices 11

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 8

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": "1312416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1770862039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 HANOVER ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021131901",
            "telephone_number": "201-562-2738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 HANOVER ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021131901",
            "telephone_number": "617-643-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Friendship St",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "RI",
            "postal_code": "028402209",
            "country_code": "US",
            "telephone_number": "401-845-1281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUK",
        "first_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-04",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD19880",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2012026099",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "291101",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "BP10039786",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD15094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.