Individual provider Active NPI

Natalia Maximovsky, NP

  • Adult Health Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1265990097
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
309106 Issued in NY
Practice address
11 Ralph PL
Staten Island, NY 10304-4401
Phone
(347) 377-1979
NPI assigned
Mar 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 309106 NY Primary

Addresses

Primary practice location

11 Ralph PL
Staten Island, NY 10304-4401

Mailing address

11 Ralph PL
Staten Island, NY 10304-4401
Phone (718) 954-2202

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
I20190708002709 NY Practitioner - Nurse Practitioner 1052646494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lindenwood Medical PCGroup PAC ID 5193861763, 3 clinicians

Practice addresses (Care Compare)

11 Ralph PL
Suite 112
Staten Island, NY 10304-4408
Phone (718) 954-2202

Hospital & facility affiliations

  • Girling Health Care of New York Home health agency, Brooklyn, NY, CCN 337243
  • M J H S Home Care Home health agency, Brooklyn, NY, CCN 337061

Merit-based Incentive Payment System (MIPS)

Final score
71.48 of 100Reported as apm
Quality
82.91
Promoting interoperability
5.67
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
309106NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adult Geriatric Health NP PC Adult Health Current Accepting new patients
Maimonides Medical Center Current Accepting new patients
Lindenwood Medical PC CurrentSince May 18, 2019 Accepting new patients

Locations

11 Ralph Pl
Ste 112
Staten Island, NY 10304
Phone (718) 273-8888

Interoperability endpoints

  • Direct secure messaging: nataliamaximovsky@mai.allscriptsdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1265990097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 RALPH PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044401",
            "telephone_number": "718-954-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 RALPH PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044401",
            "telephone_number": "347-377-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXIMOVSKY",
        "first_name": "NATALIA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "309106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.