NPIMap

Individual provider Active NPI

Maxwell Van Hoven, MD

  • Family Medicine Physician
  • Pawtucket, RI
National Provider Identifier
1083354757
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
LP05766 Issued in RI
Practice address
111 Brewster St
Pawtucket, RI 02860-4400
Phone
(401) 737-7000
NPI assigned
Mar 31, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X LP05766 RI Primary

Addresses

Primary practice location

111 Brewster St
Pawtucket, RI 02860-4400

Mailing address

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250910000009 PA Practitioner - Internal Medicine 3375923212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

7133 Roosevelt Blvd
Philadelphia, PA 19149-1431
Phone (215) 333-3311

777 Township Line Rd
Suite 200
Yardley, PA 19067-5564
Phone (215) 860-0775

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health Family Medicine Current Accepting new patients
Lifespan Corporation Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Family Medicine CurrentSince Aug 25, 2025 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Aug 25, 2025 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Past Accepting new patients

Locations

7133 Roosevelt Blvd
Philadelphia, PA 19149
Phone (215) 333-3311

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Interoperability endpoints

  • Direct secure messaging: mvanhoven210709@brownhealth.medalliesdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1083354757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-737-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BREWSTER ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604400",
            "telephone_number": "401-737-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN HOVEN",
        "first_name": "MAXWELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "LP05766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.