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DR. MARK JOEL ILLUMINATI MD
NPI 1518077320
General Practice in Baltimore, MD

Active since August 30, 2006PECOS Enrolled
1212 SHORE RD, BALTIMORE, MD 21220(410) 780-3972 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Dr. Mark Joel Illuminati Md NPPES

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

DR. MARK JOEL ILLUMINATI MD (NPI 1518077320) is an individual general practice provider in Baltimore, Maryland, licensed in Maryland (D35832) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1518077320
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. MARK JOEL ILLUMINATICredential: MD
Location Address1212 SHORE RDBaltimore, MD 21220-5526
Mailing Address1212 Shore RdBaltimore, MD 21220-5526 · (410) 780-3972
Phone(410) 780-3972
Sole ProprietorYes
Enumeration DateAugust 30, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1518077320 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in MD · D35832
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
1212 SHORE RD, Baltimore, MD 21220
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mark Joel Illuminati Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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 Mark Illuminati's NPI number?

The NPI number for Mark Illuminati is 1518077320. It was assigned to this individual provider in the NPPES registry on August 30, 2006.

Where is Mark Illuminati located?

Mark Illuminati practices at 1212 Shore Rd, Baltimore, MD 21220. The listed phone number is (410) 780-3972.

What is Mark Illuminati's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Mark Illuminati enrolled in Medicare?

Yes. Mark Illuminati is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mark Illuminati was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.