Luminis Health Medical Group, LLC

Organization Active NPI Obstetrics & Gynecology Physician · Odenton, MD

NPI 1831991926 · NPPES record last updated Mar 27, 2025

Key facts

NPI
1831991926
Entity type
Organization (NPI type 2)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
Legal business name
LUMINIS HEALTH MEDICAL GROUP, LLC
Practice address
1106 Annapolis Rd Ste 220
Odenton, MD 21113-1740
Phone
(443) 481-1000
NPI assigned
Mar 27, 2025
Organization subpart
No

Authorized official

Name
Melissa Rapattoni
Title
Ao
Phone
(443) 481-5136

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MD

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050317000146 MD Part B Supplier - Clinic/Group Practice 2860447315 Receives reassigned benefits from 897 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Tax ID family
Anne Arundel Phys Group LLC (221 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207V00000X Yes

Addresses

Primary practice location

1106 Annapolis Rd Ste 220
Odenton, MD 21113-1740

Mailing address

2000 Medical Pkwy Ste 409
Annapolis, MD 21401-3746
Phone (443) 481-5136

Other providers in Odenton, MD

All providers in Odenton, MD · Obstetrics & Gynecology Physician in Maryland

Sources for this page

Verify at the official NPI Registry.