Maxwell Frederick Lydiatt, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

85467 Issued in WI

Practice address

717 N 190TH PLZ Ste 2100
Elkhorn, NE 68022-3914

Phone

(402) 354-8350

Fax

(402) 354-8355

NPI assigned

Jun 14, 2021

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Psychiatry

Education

University of Nebraska College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mental Health Emergency Center, Inc.Group PAC ID 3274916044, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mental Health Emergency Center, Inc.

  • Psychiatric Hospital
  • Milwaukee, WI
  • NPI 1255099941
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1093383325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 S 169TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681189300",
            "telephone_number": "402-354-3370",
            "fax_number": "402-354-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 N 190TH PLZ STE 2100",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680223914",
            "telephone_number": "402-354-8350",
            "fax_number": "402-354-8355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYDIATT",
        "first_name": "MAXWELL",
        "middle_name": "FREDERICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-14",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "85467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100332249",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlydiatt438301@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1525 N 12th St",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532052591",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1525 N 12th St",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532052591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• LTC Pharmacy Solutions LLC
• Peter Thomas Luckey, PT, DPT
• Leanna Ludlow, MA LIMFT LIMHP
• Kseniya Alekseyevna Lueck, PA-C
• Lucie Nze Lukula
• Daejanira Lyncook, PLMHP
• Bryan Mack, D.C.
• Garrett Raymond Mack, D.C.
• Janet Jo Macklem, M.S., CCC/SLP
• Tara Albie Madden

• Psychiatry Physician in Elkhorn, NE
• Providers in Elkhorn, NE by specialty
• Psychiatry Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.