Luminis Health Medical Group, LLC

Organization Active NPI Cognitive & Behavioral Psychologist · Annapolis, MD

NPI 1912306705 · NPPES record last updated Oct 17, 2024

Key facts

NPI
1912306705
Entity type
Organization (NPI type 2)
Primary specialty
Cognitive & Behavioral Psychologist 103TB0200X
Legal business name
LUMINIS HEALTH MEDICAL GROUP, LLC
Practice address
175 Harry S Truman Pkwy
Annapolis, MD 21401-7573
Phone
(410) 573-9000
Fax
(410) 573-9001
NPI assigned
Aug 18, 2014
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.

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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)

Locations

1997 Annapolis Exchange Pkwy
Ste 500
Annapolis, MD 21401

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP
103TB0200X Yes

Addresses

Primary practice location

175 Harry S Truman Pkwy
Annapolis, MD 21401-7573

Mailing address

1997 Annapolis Exchange Pkwy Ste 500
Annapolis, MD 21401-3275

Other names

  • Mental Health Specialist at Pathways Doing business as

Other providers in Annapolis, MD

All providers in Annapolis, MD · Cognitive & Behavioral Psychologist in Maryland

Sources for this page

Verify at the official NPI Registry.