Active NPI
Matthew Maves, MD
- Pediatrics Physician
- Cedarburg, WI
National Provider Identifier
1194253484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0000047617
- Practice address
- 7861 State Road 60
Cedarburg, WI 53012-9305 - Phone
- (262) 546-1050
- Fax
- (262) 546-1051
- NPI assigned
- May 31, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0000047617 | WI | Primary |
Addresses
Primary practice location
7861 State Road 60
Cedarburg, WI 53012-9305
Mailing address
7861 State Road 60
Cedarburg, WI 53012-9305
Phone (262) 546-1050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194253484 | Medicaid | IA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000047617 | WI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Hospital, Iowa City, Iowa | Current | Accepting new patients | |
| Children'S Medical Group | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- mmaves111754@direct.chw.org
- matthewmaves@mic.allscriptsdirect.net
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Iowa City, IA
- NPI 1982664124
-
- Pediatrics Physician
- Glendale, WI
- NPI 1134394471
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689033600000",
"number": "1194253484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7861 STATE ROAD 60",
"city": "CEDARBURG",
"state": "WI",
"postal_code": "530129305",
"telephone_number": "262-546-1050",
"fax_number": "262-546-1051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7861 STATE ROAD 60",
"city": "CEDARBURG",
"state": "WI",
"postal_code": "530129305",
"telephone_number": "262-546-1050",
"fax_number": "262-546-1051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAVES",
"first_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-31",
"last_updated": "2023-07-11",
"certification_date": "2023-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "0000047617",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1194253484",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cedarburg, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.