Jill M Maxam, SP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

013922 Issued in NY

Practice address

2150 Bleecker St
Utica, NY 13501-1738

Phone

(315) 798-4867

Fax

(315) 798-4944

NPI assigned

Mar 24, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Charles T. Sitrin Health Care Center, Inc

  • Skilled Nursing Facility
  • New Hartford, NY
  • NPI 1770589251
  NPD

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1235371139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 BLEECKER ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135011738",
            "telephone_number": "315-798-4867",
            "fax_number": "315-798-4944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 BLEECKER ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135011738",
            "telephone_number": "315-798-4867",
            "fax_number": "315-798-4944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXAM",
        "first_name": "JILL",
        "middle_name": "M",
        "credential": "SP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-24",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "013922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Mattoni
• Lauren Matyjas
• Max & Blom MD PC
• Max MD PC
• Christopher C Max, M.D.
• Kaleigh Maxim
• Gabriella Janice May, OTR/L
• Kathleen Susan Maycock, M.S. CCC-SLP
• John M Mazur, CASAC-T,CRPA,NYCPS-P
• Concetto John Mazza, DDS

• Speech-Language Pathologist in Utica, NY
• Providers in Utica, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.