Individual provider Active NPI

Max Andrew Stevens, M.D.

  • Diagnostic Radiology Physician
  • Grand Island, NE
National Provider Identifier
1346279973
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
19366 Issued in NE
Practice address
2620 W Faidley Ave
Grand Island, NE 68803-4205
Phone
(308) 382-6856
Fax
(308) 381-1560
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 19366 NE Primary
Diagnostic Radiology Physician 2085R0202X 30978 KS
Diagnostic Radiology Physician 2085R0202X 31638 IA

Addresses

Primary practice location

2620 W Faidley Ave
Grand Island, NE 68803-4205

Mailing address

2808 Old Fair Rd
Grand Island, NE 68803-5220
Phone (308) 382-6856

Other identifiers 2

IdentifierTypeStateIssuer
35012OtherNEBLUE CROSS BLUE SHIELD
300123576OtherNERAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050107000860 NE Practitioner - Diagnostic Radiology 9032167820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Iowa, RJ & L Carver College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4500 S Garnett Rd
Suite 919
Tulsa, OK 74146-5214

PO Box
Suite 24900
Omaha, NE 68124

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31638IAMDDiagnostic Radiology Physician
30978KSMDDiagnostic Radiology Physician
19366NEMDDiagnostic Radiology Physician

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.

Hospital & facility affiliations 6

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1346279973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 OLD FAIR RD",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688035220",
            "telephone_number": "308-382-6856",
            "fax_number": "308-381-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 W FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034205",
            "telephone_number": "308-382-6856",
            "fax_number": "308-381-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "MAX",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "19366",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "30978",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IA",
            "license": "31638",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "35012",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300123576",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.