Individual provider Active NPI

Maxime Junior Jean, MD/PHD

  • Student in an Organized Health Care Education/Training Program
  • Rochester, NY
National Provider Identifier
1114547957
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
601 Elmwood Ave
Neurology Clinic 681
Rochester, NY 14642
Phone
(585) 275-1200
Fax
(585) 756-5189
NPI assigned
Apr 22, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

601 Elmwood Ave
Neurology Clinic 681
Rochester, NY 14642

Mailing address

93 Smyles Dr
Rochester, NY 14609-3130
Phone (786) 283-0874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20240515001547 NY Practitioner - Neurology 7416371091 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Rochester School of Medicine and Dentistry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
U of R Neurology DepartmentGroup PAC ID 1456248699, 107 clinicians

Practice addresses (Care Compare)

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 275-1200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Jul 1, 2024 Accepting new patients
U of R Neurology Department CurrentSince Jul 1, 2024 Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Jul 1, 2024 Accepting new patients
University of Rochester Current Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients

Locations

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

601 Elmwood Ave
#681
Rochester, NY 14642
Phone (585) 275-1200

601 Elmwood Ave
#278984
Rochester, NY 14642
Phone (585) 275-1200

Interoperability endpoints

  • Direct secure messaging: mjean87635@direct.urmc.rochester.edu

Organizations & group practices 6

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 2

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": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1114547957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 SMYLES DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146093130",
            "telephone_number": "786-283-0874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "NEUROLOGY CLINIC 681",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14642",
            "telephone_number": "585-275-1200",
            "fax_number": "585-756-5189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN",
        "first_name": "MAXIME",
        "middle_name": "JUNIOR",
        "credential": "MD/PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.