Gerald N Maesaka, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01044360 Issued in IN

Practice address

601 Stadium Mall Dr
West Lafayette, IN 47907-2052

Phone

(765) 494-1700

Fax

(765) 496-1227

NPI assigned

Nov 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gerald.maesaka.1@29127.direct.athenahealth.com

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

• Trustees of Purdue University

  • Hearing and Speech Clinic/Center
  • West Lafayette, IN
  • NPI 1619055712
  Medicare reassignment NPD
• Trustees of Purdue University

  • Federally Qualified Health Center (FQHC)
  • Delphi, IN
  • NPI 1477549731
  NPD
• Trustees of Purdue University

  • Federally Qualified Health Center (FQHC)
  • Wolcott, IN
  • NPI 1598111791
  NPD
• St. Joseph Primary Care, LLC

  • Family Medicine Physician
  • Kokomo, IN
  • NPI 1982736377
  NPD (past)

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241740800000",
    "number": "1073594784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 STADIUM MALL DR",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479072052",
            "telephone_number": "765-494-1700",
            "fax_number": "765-496-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 STADIUM MALL DR",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479072052",
            "telephone_number": "765-494-1700",
            "fax_number": "765-496-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAESAKA",
        "first_name": "GERALD",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2009-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01044360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200148130",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristal Aline Lykins
• Kristen Nicole Lyons
• Michael Andrew Lyznicki
• Imogen Qinqing Ma
• Martin J Maassen, M.D.
• Colleen Maguire Jackson, PH.D.
• Rutu R Mahajan, MD
• Megan Mahoney, LCSW
• Ryelee Elise Mains
• Herve Malan, PHARMD

• Family Medicine Physician in West Lafayette, IN
• Providers in West Lafayette, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.