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	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1578441267
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUMINIS HEALTH MEDICAL GROUP, LLC

Provider Business Mailing Address
First Line	:	2002 MEDICAL PKWY STE 409
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-3046
Country	:	US
Telephone Number	:	443-481-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	14090 HG TRUEMAN RD STE 1100
Second Line	:
City	:	SOLOMONS
State	:	MD
Zip	:	20688-3151
Country	:	US
Telephone Number	:	410-414-4740
Fax Number	:	410-414-4741

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

Provider Enumeration Date	:	08/22/2025
Last Update Date	:	08/22/2025

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