Individual provider Active NPI

Peter A Maves, PH.D.

  • Clinical Psychologist
  • Longmont, CO
National Provider Identifier
1215995154
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
995 Issued in CO
Practice address
1079 S Hover St Ste 200
Longmont, CO 80501-7924
Phone
(303) 827-2485
Fax
(303) 442-7312
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 995 CO Primary

Addresses

Primary practice location

1079 S Hover St Ste 200
Longmont, CO 80501-7924

Mailing address

1079 S Hover St Ste 200
Longmont, CO 80501-7924
Phone (303) 827-2485

Other identifiers 1

IdentifierTypeStateIssuer
07009954MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20050913000786 CO Practitioner - Clinical Psychologist 1254364086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Colorado School of Medicine, Denver, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1079 S Hover St
Suite 200
Longmont, CO 80501-7924
Phone (303) 827-2485

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
995COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Peter a. Maves, PH.D, PLLC Clinical CurrentSince May 10, 2023 Accepting new patients

Locations

1079 S Hover St
Ste 200
Longmont, CO 80501
Phone (303) 827-2485

Organizations & group practices 1

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1215995154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1079 S HOVER ST STE 200",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805017924",
            "telephone_number": "303-827-2485",
            "fax_number": "303-442-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1079 S HOVER ST STE 200",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805017924",
            "telephone_number": "303-827-2485",
            "fax_number": "303-442-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVES",
        "first_name": "PETER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07009954",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.