Active NPI
Maxine Kidder, P.N.P.
- Pediatric Nurse Practitioner
- Lockport, NY
National Provider Identifier
1124084090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 380525
- Practice address
- 139 Professional Pkwy
Lockport, NY 14094-5369 - Phone
- (716) 433-6711
- Fax
- (716) 433-0546
- NPI assigned
- Apr 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 380525 | NY | Primary |
Addresses
Primary practice location
139 Professional Pkwy
Lockport, NY 14094-5369
Mailing address
139 Professional Pkwy
Lockport, NY 14094-5369
Phone (716) 433-6711
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000560073003 | Other | NY | BLUE CROSS/BLUE SHIELD |
| 9512424 | Other | NY | INDEPENDENT HEALTH |
| 01400724 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 380525 | NY | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| William J Baier MD PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Adolescent Medicine Physician
- Lockport, NY
- NPI 1083820351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1124084090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "139 PROFESSIONAL PKWY",
"city": "LOCKPORT",
"state": "NY",
"postal_code": "140945369",
"telephone_number": "716-433-6711",
"fax_number": "716-433-0546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "139 PROFESSIONAL PKWY",
"city": "LOCKPORT",
"state": "NY",
"postal_code": "140945369",
"telephone_number": "716-433-6711",
"fax_number": "716-433-0546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDDER",
"first_name": "MAXINE",
"credential": "P.N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-21",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NY",
"license": "380525",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "000560073003",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENT HEALTH",
"identifier": "9512424",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01400724",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lockport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.