| Lumin Health Pg | |
|
53 Langley Rd Ste 250 Newton MA 02459-1945 | |
| (153) 881-9909 | |
| (617) 863-8844 |
| Full Name | Lumin Health Pg |
|---|---|
| Speciality | Clinic/Center |
| Location | 53 Langley Rd Ste 250, Newton, Massachusetts |
| Authorized Official Name and Position | Benjamin Louis Yudkoff (OWNER) |
| Authorized Official Contact | 2019530432 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lumin Health Pg 53 Langley Rd Ste 250 Newton MA 02459-1945 Ph: (617) 863-8810 | Lumin Health Pg 53 Langley Rd Ste 250 Newton MA 02459-1945 Ph: (153) 881-9909 |
| NPI Number | 1538819909 |
|---|---|
| Provider Enumeration Date | 03/28/2022 |
| Last Update Date | 09/26/2023 |
| Certification Date | 09/26/2023 |
| Medicare PECOS PAC ID | 3678950649 |
|---|---|
| Medicare Enrollment ID | O20220512000770 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538819909 | NPI | - | NPPES |
| Provider Name | Benjamin L Yudkoff |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962727966 PECOS PAC ID: 4284856550 Enrollment ID: I20141121000686 |
| Provider Name | Jacob L. Taylor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902198211 PECOS PAC ID: 7315196516 Enrollment ID: I20160930001787 |
| Provider Name | Andrew Stephen Cruz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730569674 PECOS PAC ID: 3274820071 Enrollment ID: I20190508001329 |
| Provider Name | Gabriel M. Tobia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689093791 PECOS PAC ID: 1355643941 Enrollment ID: I20191029001531 |
| Provider Name | William Kromka |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558822593 PECOS PAC ID: 3779975438 Enrollment ID: I20220110001706 |
| Provider Name | Julie West |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013527423 PECOS PAC ID: 1153732870 Enrollment ID: I20220913003628 |
| Provider Name | Kerry Parsons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881342913 PECOS PAC ID: 7719374024 Enrollment ID: I20220923001051 |
| Provider Name | Charles A Ventriglia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619437696 PECOS PAC ID: 2961835335 Enrollment ID: I20221220002590 |
| Provider Name | James Matthew Neal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063116374 PECOS PAC ID: 5092171520 Enrollment ID: I20230525000910 |
| Provider Name | Aakash Sathappan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366903882 PECOS PAC ID: 7810354206 Enrollment ID: I20230530001919 |
| Provider Name | Anna Hollyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023881919 PECOS PAC ID: 1759723927 Enrollment ID: I20240521000629 |
| Provider Name | Elizabeth Shea Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649304296 PECOS PAC ID: 5294177911 Enrollment ID: I20240528001092 |
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