Individual provider Active NPI

Daniel Redziniak, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Annapolis, MD
National Provider Identifier
1942403514
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
D67591 Issued in MD
Practice address
2000 Medical Pkwy
Suite 101
Annapolis, MD 21401-3742
Phone
(410) 268-8862
Fax
(410) 268-0380
NPI assigned
Jun 8, 2007
Last updated
Mar 4, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X D67591 MD
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X D67591 MD Primary

Addresses

Primary practice location

2000 Medical Pkwy
Suite 101
Annapolis, MD 21401-3742

Mailing address

2000 Medical Pkwy
Suite 101
Annapolis, MD 21401-3742
Phone (410) 268-8862

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
I20081007000062 MD Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 8628146495 Reassigns benefits to 2 organizations
I20081028000815 DC Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 8628146495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2002
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)

1106 Annapolis Rd
Suite 130
Odenton, MD 21113-1739
Phone (410) 268-8862

2000 Medical Pkwy
Suite 101
Annapolis, MD 21401-3743
Phone (410) 268-8862

2001 Medical Pkwy
Annapolis, MD 21401-3280
Phone (443) 481-1000

2003 Medical Pkwy
Annapolis, MD 21401-3081

2003 Medical Pkwy Wayson Pavillion
Advanced Internal Medicine Residenc
Annapolis, MD 21401-3081
Phone (443) 951-4286

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

4175 N Hanson CT
Suite 301
Bowie, MD 20716-3186
Phone (410) 268-8862

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D67591MDMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Jun 1, 2022 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Apr 23, 2020 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Apr 23, 2020 Accepting new patients
Luminis Health Medical Group, LLC Orthopaedic Surgery CurrentSince May 1, 2009 Accepting new patients
Orthopaedic and Sports Medicine Center LLC Sports Medicine Past Accepting new patients
Orthopaedic and Sports Medicine Center LLC Sports Medicine Past Accepting new patients

Locations

2000 Medical Pkwy
Ste 101
Annapolis, MD 21401
Phone (410) 295-8900

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

201 Defense Hwy
Ste 150
Annapolis, MD 21401

15500 Annapolis Rd
Ste 102
Bowie, MD 20715
Phone (301) 805-0190

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

4175 N Hanson Ct
Ste 301
Bowie, MD 20716
Phone (301) 805-0190

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

Interoperability endpoints

  • Direct secure messaging: dredziniak4811@direct.aahs.org

Organizations & group practices 8

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.

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": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1942403514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 MEDICAL PKWY",
            "address_2": "SUITE 101",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013742",
            "telephone_number": "410-268-8862",
            "fax_number": "410-268-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MEDICAL PKWY",
            "address_2": "SUITE 101",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013742",
            "telephone_number": "410-268-8862",
            "fax_number": "410-268-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDZINIAK",
        "first_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MD",
            "license": "D67591",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MD",
            "license": "D67591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.