Dinara Maksa, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

015776-1 Issued in NY

Practice address

61 Deepdene Rd
Forest Hills, NY 11375-6061

Phone

(917) 509-0139

Fax

(718) 836-5147

NPI assigned

Oct 18, 2006

Last updated

Oct 25, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382659200000",
    "number": "1124109939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 DEEPDENE RD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756061",
            "telephone_number": "917-509-0139",
            "fax_number": "718-836-5147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 DEEPDENE RD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756061",
            "telephone_number": "917-509-0139",
            "fax_number": "718-836-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKSA",
        "first_name": "DINARA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2013-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015776-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02547148",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mainline Medical PC
• Walker Mainwaring, MD
• Majer Rosenfeld MD PC
• Wai Yin Mak
• Elizabeth Makh
• Jonathan Maksumov, FNP
• Bella Maksumova
• Julinda Maksuti, MD
• Mal Drugs Inc
• Ariel Malakov

• Clinical Psychologist in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; 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.