Active NPI
Max Andrew Stevens, M.D.
- Diagnostic Radiology Physician
- Grand Island, NE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 19366
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35012 | Other | NE | BLUE CROSS BLUE SHIELD |
| 300123576 | Other | NE | RAILROAD 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
Enrollment records 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| 31638 | IA | MD | Diagnostic Radiology Physician |
| 30978 | KS | MD | Diagnostic Radiology Physician |
| 19366 | NE | MD | Diagnostic 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.
-
- Diagnostic Radiology Physician
- Omaha, NE
- NPI 1700802154
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba CHI Health Lakeside
- General Acute Care Hospital
- Omaha, NE
- NPI 1649355132
-
- Rural Acute Care Hospital
- Fremont, NE
- NPI 1033698543
-
- Rural Acute Care Hospital
- Fremont, NE
- NPI 1376498543
-
dba Methodist Hospital
- General Acute Care Hospital
- Omaha, NE
- NPI 1427147883
-
dba The Nebraska Medical Center - Nebraska Medicine
- General Acute Care Hospital
- Omaha, NE
- NPI 1356307581
-
dba Methodist Jennie Edmundson
- General Acute Care Hospital
- Council Bluffs, IA
- NPI 1457448755
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
- 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.