Individual provider Active NPI

Marius Maxwell, M.D.

  • Neurological Surgery Physician
  • Anchorage, AK
National Provider Identifier
1285693077
Registry record updated Jun 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
7202 Issued in AK
Practice address
3650 Lake Otis Pkwy
Suite 202
Anchorage, AK 99508-5218
Phone
(907) 222-6500
Fax
(907) 222-6550
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 5262 SD
Neurological Surgery Physician 207T00000X MD2011-0824 NM
Neurological Surgery Physician 207T00000X 7202 AK Primary

Addresses

Primary practice location

3650 Lake Otis Pkwy
Suite 202
Anchorage, AK 99508-5218

Mailing address

3650 Lake Otis Parkway, Ste 202
Anchorage, AK 99508-0000
Phone (907) 222-6500

Other identifiers 6

IdentifierTypeStateIssuer
6100890MedicaidSD
119113600MedicaidWY
312588OtherWYWYOMING BCBS PIN
24245OtherNDND BCBS PIN
4995818OtherSDWELLMARK BCBS PIN
3505619MedicaidMT

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7202AKMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Arctic Surgery Center LLC CurrentSince Jun 9, 2024 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Baptist Health Medical Group Inc Neurological Surgery Past Accepting new patients
Evergreen Anesthesia LLC Past Accepting new patients
Neuro Surgical & Spinal Surgery Associates, P.C. Neurological Surgery PastSince Feb 1, 2005 Accepting new patients

Locations

1335 Gambell St
Anchorage, AK 99501
Phone (907) 222-6500

Organizations & group practices 5

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401667200000",
    "number": "1285693077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 LAKE OTIS PARKWAY, STE 202",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995080000",
            "telephone_number": "907-222-6500",
            "fax_number": "907-222-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 LAKE OTIS PKWY",
            "address_2": "SUITE 202",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085218",
            "telephone_number": "907-222-6500",
            "fax_number": "907-222-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "MARIUS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2014-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "SD",
            "license": "5262",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NM",
            "license": "MD2011-0824",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AK",
            "license": "7202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6100890",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119113600",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WYOMING BCBS PIN",
            "identifier": "312588",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND BCBS PIN",
            "identifier": "24245",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS PIN",
            "identifier": "4995818",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3505619",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.