Individual provider Active NPI

Peter G Maxwell, PA-C

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1174825657
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
014448 Issued in NY
Practice address
601 Elmwood Ave
Rochester, NY 14642-8655
Phone
(585) 275-4800
NPI assigned
Dec 3, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 014448 NY Primary

Addresses

Primary practice location

601 Elmwood Ave
Rochester, NY 14642-8655

Mailing address

32 Harwood LN
East Rochester, NY 14445-1914
Phone (585) 507-3987

Other identifiers 1

IdentifierTypeStateIssuer
014448OtherNYLICENSE NUMBER

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110321000941 NY Practitioner - Physician Assistant 5890978399 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Practice addresses (Care Compare)

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-4000

1425 Portland Ave
Rochester, NY 14621-3011
Phone (585) 922-4000

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
014448NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. CurrentSince Jan 5, 2026 Accepting new patients
Rochester General Hospital Physician Assistant CurrentSince Jan 9, 2024 Accepting new patients
The Unity Hospital of Rochester CurrentSince Jan 5, 2026 Accepting new patients
Western New York Medical Practice, P.C. CurrentSince Jan 5, 2026 Accepting new patients
Rochester General Hospital Past Accepting new patients

Locations

1425 Portland Ave
Ste 173
Rochester, NY 14621

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1415 Portland Ave
Ste 245
Rochester, NY 14621
Phone (585) 922-4715

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

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291334400000",
    "number": "1174825657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 HARWOOD LN",
            "city": "EAST ROCHESTER",
            "state": "NY",
            "postal_code": "144451914",
            "telephone_number": "585-507-3987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146428655",
            "telephone_number": "585-275-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "PETER",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-03",
        "last_updated": "2010-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "014448",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.