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1073580205

NPI Code Detail

MEDICARE: LUMINIS HEALTH MEDICAL GROUP, LLC

MEDICARE: LUMINIS HEALTH MEDICAL GROUP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VM0101X	Maternal & Fetal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	760BCE	OTHER		BCBS
2	K480	OTHER		BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073580205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUMINIS HEALTH MEDICAL GROUP, LLC

Provider Business Mailing Address
First Line	:	2001 MEDICAL PKWY STE 409
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-3773
Country	:	US
Telephone Number	:	443-481-1000
Fax Number	:	443-481-6515

Provider Business Practice Location Address
First Line	:	185 HARRY S TRUMAN PKWY STE 120
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-7580
Country	:	US
Telephone Number	:	410-224-4442
Fax Number	:	410-224-8898

Authorized Official
Title or Position	:	AO
Name	:	MELISSA RAPATTONI
Credential	:
Telephone Number	:	443-481-5136

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	02/02/2026

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Directions to “LUMINIS HEALTH MEDICAL GROUP, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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