NPIMap

Individual provider Active NPI

Stephen D Maxwell, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Roseville, CA
National Provider Identifier
1043223936
Registry record updated May 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
A78656 Issued in CA
Practice address
Three Medical Plaza Drive
Suite 130
Roseville, CA 95661-3037
Phone
(916) 773-8750
Fax
(916) 773-8751
NPI assigned
Aug 14, 2006
Last updated
May 24, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X A78656 CA Primary

Addresses

Primary practice location

Three Medical Plaza Drive
Suite 130
Roseville, CA 95661-3037

Mailing address

P.O. Box 255228
Sacramento, CA 95865-5228
Phone (916) 773-8750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040727001034 CA Practitioner - Thoracic SurgeryPractitioner - General Surgery 1951386127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: General Surgery
Education
University of Missouri, Columbia School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 454-6868

2800 L St
Sacramento, CA 95816-5616

8 Medical Plaza Dr
Roseville, CA 95661-3106
Phone (916) 782-5106

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A78656CAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Jun 4, 2012 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Jun 4, 2012 Accepting new patients
Dignity Health Past Accepting new patients
Sutter Regional Medical Foundation Past Accepting new patients
Stephen Maxwell M.D., Inc. Thoracic Surgery (Cardiothoracic Vascular Surgery) PastSince May 24, 2004 Accepting new patients
Southwest Medical Care Corporation Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

3 Medical Plaza Dr
Ste 130
Roseville, CA 95661
Phone (916) 773-8750

2800 L St
Ste 300
Sacramento, CA 95816
Phone (916) 453-3300

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: smaxwell115482@hisp.ehr.sutterhealth.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1043223936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228",
            "telephone_number": "916-773-8750",
            "fax_number": "916-773-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THREE MEDICAL PLAZA DRIVE",
            "address_2": "SUITE 130",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613037",
            "telephone_number": "916-773-8750",
            "fax_number": "916-773-8751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "STEPHEN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "A78656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.