Individual provider Active NPI

Maxine Titterton, DO

  • Student in an Organized Health Care Education/Training Program
  • Mineola, NY
National Provider Identifier
1174317184
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
101 Mineola Blvd
Mineola, NY 11501-4089
Phone
(516) 240-7200
NPI assigned
Apr 7, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

101 Mineola Blvd
Mineola, NY 11501-4089

Mailing address

222 Station PLZ N Ste 509
Mineola, NY 11501-3893

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
Credentials
Doctor of Osteopathy

Interoperability endpoints

  • Direct secure messaging: mtitterton693530@nyumc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1174317184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 STATION PLZ N STE 509",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MINEOLA BLVD",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014089",
            "telephone_number": "516-240-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITTERTON",
        "first_name": "MAXINE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "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 Mineola, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.