Dominic J Maxwell, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

00025983 Issued in AL

Practice address

15 Church St
Vineyard Haven, MA 02568

Phone

(508) 687-9592

Fax

(508) 687-9567

NPI assigned

May 8, 2006

Last updated

Jun 23, 2011By the provider in NPPES

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in MA, MD2 enrollments

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 2

Specialty

Psychiatry

Education

University of North Carolina at Chapel Hill School of Medicine, 1996

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Fairwinds-Nantuckets Counseling CenterGroup PAC ID 7517997992, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: family&childrensservicesofnantucketcounty.dominicmaxwell@132055.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fairwinds-Nantuckets Counseling Center

  • Community/Behavioral Health Agency
  • Nantucket, MA
  • NPI 1275621385
  Medicare reassignment Care Compare group NPD
• Martha's Vineyard Community Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oak Bluffs, MA
  • NPI 1659387074
  Medicare reassignment NPD
• Fairwinds-Nantucket's Counseling Center, Inc

  • Developmental - Behavioral Pediatrics Physician
  • Nantucket, MA
  • NPI 1629537444
  NPD (past)
• Grayson and Associates PC

  • Psychiatry Physician
  • Birmingham, AL
  • NPI 1194772442
  NPD (past)
• Natchaug Hospital, Inc.

  • Psychiatric Hospital
  • Mansfield Center, CT
  • NPI 1295811321
  NPD (past)
• SVPS Psychiatric Services LLC

  • Psychiatry Physician
  • Birmingham, AL
  • NPI 1447528591
  NPD (past)
• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  NPD (past)

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1134178106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CANTERBURY LN",
            "city": "VINEYARD HAVEN",
            "state": "MA",
            "postal_code": "025685658",
            "telephone_number": "508-687-9592",
            "fax_number": "508-687-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CHURCH ST",
            "city": "VINEYARD HAVEN",
            "state": "MA",
            "postal_code": "02568",
            "telephone_number": "508-687-9592",
            "fax_number": "508-687-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "DOMINIC",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "00025983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009933454",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF AL",
            "identifier": "051530946",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martha's Vineyard School District
• Martha'Svinyard Community Services
• Marthas Vineyard Community Services Inc.
• Marthas Vineyard Eye Care Inc
• David Rodney Matthew
• Kelly Merrill McCarron
• Michelle McCrumb, D.P.M.
• Mary Ellen McElroy, MA, LMHC
• Courtenay Winfield McKinley-Griffin, RN
• Judith A Merion, M.D.

• Psychiatry Physician in Vineyard Haven, MA
• Providers in Vineyard Haven, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; 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.