Individual provider Active NPI

Maximilian Fischer, D.P.T.

  • Physical Therapist
  • Riverhead, NY
National Provider Identifier
1346002912
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
051504 Issued in NY
Practice address
518 East Main Street
Suite 100
Riverhead, NY 11901-2529
Phone
(631) 490-5503
Fax
(631) 727-0678
NPI assigned
Jan 29, 2024
Last updated
Jan 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 051504 NY Primary

Addresses

Primary practice location

518 East Main Street
Suite 100
Riverhead, NY 11901-2529

Mailing address

191 Patchogue-Yaphank Road
East Patchogue, NY 11772-4899
Phone (631) 775-0971

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240510000422 NY Practitioner - Physical Therapist in Private Practice 3779924543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Care Physical Therapy and Rehabilitation P.CGroup PAC ID 7517023351, 23 clinicians

Practice addresses (Care Compare)

518 E Main St
Suite 100
Riverhead, NY 11901-2529
Phone (631) 591-0838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
051504NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Care Physical Therapy and Rehabilitation P.C Physical Therapist CurrentSince Mar 27, 2024 Accepting new patients

Locations

191 Patchogue Yaphank Rd
East Patchogue, NY 11772
Phone (631) 775-0971

518 E Main St
Ste 100
Riverhead, NY 11901
Phone (631) 490-5503

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1346002912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 PATCHOGUE-YAPHANK ROAD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724899",
            "telephone_number": "631-775-0971",
            "fax_number": "631-475-0975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 EAST MAIN STREET",
            "address_2": "SUITE 100",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012529",
            "telephone_number": "631-490-5503",
            "fax_number": "631-727-0678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "MAXIMILIAN",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "051504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.