LIFEBRIDGE CARDIOLOGY OF PARKVILLE, LLC
NPI 1013319011
Internal Medicine - Cardiovascular Disease in Lutherville, MD

Q: What is Lifebridge Cardiology Of Parkville, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Active since September 22, 2014

12221 TULLAMORE RD STE 3, LUTHERVILLE, MD 21093(410) 308-7855 Get Directions Write a Review

NPPES record last updated: July 31, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 30, 2016, Nov 13, 2015 (2 updates tracked since 2015).

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About Lifebridge Cardiology Of Parkville, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFEBRIDGE CARDIOLOGY OF PARKVILLE, LLC (NPI 1013319011) is a healthcare organization registered as a cardiovascular disease in Lutherville, Maryland and active in the NPI registry since September 2014. The organization maintains a secondary practice location in Randallstown and lists Mary Wright-sisk, Director, as its authorized official.

NPPES Registry Identity

NPI1013319011

Entity TypeOrganization

Primary Taxonomy207RC0000X

Legal Business NameLIFEBRIDGE CARDIOLOGY OF PARKVILLE, LLC

Location Address12221 TULLAMORE RD STE 3Lutherville, MD 21093-7816

Mailing Address12221 Tullamore Rd Ste 3Lutherville, MD 21093-7816 · (410) 308-7855 · Fax (410) 308-7856

Phone(410) 308-7855

Organization SubpartNo

Authorized OfficialMary Wright-siskDirector · (443) 422-9941

Enumeration DateSeptember 22, 2014

Last NPPES UpdateJuly 31, 20252 updates tracked since enumeration

NPPES CertifiedJuly 31, 2025

✔ NPI 1013319011 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

12221 TULLAMORE RD STE 3, Lutherville, MD 21093

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Secondary Practice Location 1

Location 15415 Old Court Rd, Suite 101Randallstown, MD 21133-5170 · Phone (410) 308-7855 · Fax (410) 308-7856

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lifebridge Cardiology Of Parkville, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Lifebridge Cardiology Of Parkville, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Ijaz Khan, M.D.

Cardiovascular Disease (Cardiology)

NPI 1851348155

5415 OLD COURT RD SUITE 101
Randallstown, MD 21133

(410) 496-8741

✔ PECOS✔ Accepts Medicare9.5 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lifebridge Cardiology Of Parkville, LLC's NPI number?

The NPI number for Lifebridge Cardiology Of Parkville, LLC is 1013319011. It was assigned to this organization in the NPPES registry on September 22, 2014.

Where is Lifebridge Cardiology Of Parkville, LLC located?

Lifebridge Cardiology Of Parkville, LLC is located at 12221 Tullamore Rd Ste 3, Lutherville, MD 21093. The listed phone number is (410) 308-7855.

What is Lifebridge Cardiology Of Parkville, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Lifebridge Cardiology Of Parkville, LLC enrolled in Medicare?

Yes. Lifebridge Cardiology Of Parkville, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lifebridge Cardiology Of Parkville, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Cardiovascular Disease (Cardiology)) reassigns their Medicare billing to Lifebridge Cardiology Of Parkville, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Lifebridge Cardiology Of Parkville, LLC was last updated on July 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.