Luminis Health Medical Group, LLC
Organization Active NPI Surgery Physician · Chester, MD
NPI 1942528591 · NPPES record last updated Oct 15, 2024
Key facts
- NPI
- 1942528591
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- LUMINIS HEALTH MEDICAL GROUP, LLC
- Practice address
- 1630 Main St Ste 112
Chester, MD 21619-2792 - Phone
- (443) 481-5300
- Fax
- (443) 481-6705
- NPI assigned
- May 6, 2010
- Organization subpart
- No
Authorized official
- Name
- Melissa Rapattoni
- Title
- Ao
- Phone
- (443) 481-5136
Corporate family (same tax ID) 19
Practitioners 4
-
Alec Steven Rogness, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | Yes |
Addresses
Primary practice location
1630 Main St Ste 112
Chester, MD 21619-2792
Mailing address
PO Box 12622
Belfast, ME 04915-4017
Phone (443) 481-6573
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 407175131 | Medicaid | MD | |
| CRV6BR | Other | MD | BCBS |
| V874 | Other | DC | BCBS |
Other names
- The Breast Center
Other providers in Chester, MD
- Luminis Health Medical Group, LLC
- Luminis Health Medical Group, LLC
- Luminis Health Medical Group, LLC
- Luminis Health Medical Group, LLC
- Luminis Health Medical Group, LLC
- Mark OB Peeler MD PA
- Maryland CVS Pharmacy, L.L.C.
- Massage by Jess LLC
- Andrea Michelle Matthews
- Suzanne Matthews
All providers in Chester, MD · Surgery Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.