NPIMap

Organization Active NPI

Maxim Healthcare Services, Inc,

  • Home Health Agency
  • Las Vegas, NV
National Provider Identifier
1366523532
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
524HHA-12 Issued in NV
Legal business name
MAXIM HEALTHCARE SERVICES, INC,
Practice address
3930 Howard Hughes Pkwy Ste 300
Las Vegas, NV 89169-0946
Phone
(702) 560-2192
NPI assigned
Oct 17, 2006
Last updated
Mar 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Authorized official

Name
David Kowalczyk
Title
Controller
Phone
(410) 910-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 524HHA-12 NV Primary

Addresses

Primary practice location

3930 Howard Hughes Pkwy Ste 300
Las Vegas, NV 89169-0946

Mailing address

7227 Lee Deforest Drive
Columbia, MD 21046
Phone (410) 910-1500

Other identifiers 1

IdentifierTypeStateIssuer
3002095MedicaidNV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060328000210 NV Part A Provider - Home Health Agency 1658288410 Practice locations: Las Vegas, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366523532. Details of each certification follow.

Home health agency certification: CCN 297085

Legal name
MAXIM HEALTHCARE SERVICES INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 14, 1997
Last certification
Feb 11, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Sep 2, 1988 in MD
Enrollment address
1771E Flamingo Rd 220
Las Vegas, NV 89119-5155

Care Compare: Home health agency

Medicare Care Compare
Listed as
Maxim Healthcare Services IncCCN 297085 · All quality measures
Ownership
Proprietary
Certified
Jul 14, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing

National Provider Directory

National Provider Directory
Tax ID family
Maxim Healthcare Servise337 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 10

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Maxim Healthcare Services Inc Organization, Columbia, MD Other Sep 2, 1988 100%
Joseph W Marshall Individual Corporate DirectorBoard Member Jul 1, 2017
Randall D Sones Individual Corporate DirectorBoard Member Aug 25, 2009
David S. Kowalczyk Individual W-2 Managing EmployeeRegional VP Finance Oct 15, 2012
Raymond a Carbone Individual Corporate OfficerVice President/Treasurer/Cfo Jan 1, 2014
Toni-Jean L Friedman Individual Corporate OfficerVP, General Counsel, Secretary Nov 1, 2009
Oak Investment Trust Organization, Tampa, FL 5% Or Greater Indirect Ownership Interest Mar 18, 2019 38.89%
Stephen J Bisciotti Individual 5% Or Greater Indirect Ownership Interest Mar 18, 2019 19.94%
Daniel T Lubinsky Individual W-2 Managing EmployeeAdministrator/ Account Manager Jun 25, 2009
Oak Investment Trust II Organization, Tampa, FL 5% Or Greater Indirect Ownership Interest Mar 18, 2019 39.35%
James C Davis Individual Corporate DirectorBoard Member Sep 2, 1988
Maxim Healthcare Services Holdings, Inc. Organization, Columbia, MD Corporation, Holding company, For-profit 5% Or Greater Direct Ownership Interest Mar 18, 2019 100%
William J Butz Individual Corporate OfficerPresident/Ceo Oct 15, 2012
Corporate DirectorBoard Member Apr 25, 2016

All facility ownership & control disclosures 26

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Maxim Healthcare Services IncPueblo, CO, CCN 067413 Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services IncPoland, OH, CCN 368042 Home health agency Other (100%) Jan 9, 2006
Maxim Healthcare Services IncPittsburgh, PA, CCN 397783 Home health agency Other (100%) Jan 9, 2006
Maxim Healthcare Services IncTucson, AZ, CCN 037228 Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services IncSandy, UT, CCN 467212 Home health agency Other Jan 9, 2006
Maxim Healthcare Services IncBedford, NH, CCN 307085 Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services IncHarrisburg, PA, CCN 397789 Home health agency Other Jan 9, 2006
Maxim Healthcare Services, Inc.Miamisburg, OH, CCN 368006 Home health agency Other Jan 9, 1996
Maxim Healthcare Services IncPlains, PA, CCN 398016 Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services IncPhoenix, AZ, CCN 037242 Home health agency Other (100%) Apr 25, 2006
Maxim Healthcare Services IncMadison, WI, CCN 527290 Home health agency Other Jan 9, 2006
Maxim Healthcare Services IncCanton, OH, CCN 368007 Home health agency Other (100%) Jan 9, 2006
Maxim Healthcare Services IncToledo, OH, CCN 367799 Home health agency Other Jan 9, 2006
Maxim Healthcare Services IncReno, NV, CCN 297049 Home health agency Other (100%) Jan 9, 2006
Maxim Healthcare Services IncOxnard, CA, CCN 058352 Home health agency Other Jan 30, 2006
Maxim Healthcare Services IncAnchorage, AK, CCN 027032 Home health agency Other Jan 9, 2006
Maxim Healthcare Services IncFresno, CA, CCN 058323 Home health agency Other Jan 9, 2006
Maxim Healthcare Services IncAllentown, PA, CCN 398065 Home health agency Other (100%) Jun 1, 2007
Maxim Healthcare Services IncColorado Springs, CO, CCN 067325 Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services IncLa Junta, CO, CCN 067466 Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services IncSan Luis Obispo, CA, CCN 059129 Home health agency Other (100%) Dec 4, 2009
Maxim Healthcare Services IncRoseville, CA, CCN 059117 Home health agency Operational/Managerial Control (100%) Jan 1, 2009
Maxim Healthcare Services IncYork, PA, CCN 398132 Home health agency Other (100%) Apr 28, 2010
Maxim Healthcare Services IncEvansville, IN, CCN 157680 Home health agency Other (100%) Jun 30, 2011
Maxim Healthcare Services IncCrown Point, IN, CCN 157679 Home health agency Other (100%) Jun 30, 2011
Maxim Healthcare Services IncLos Angeles, CA, CCN 053198 Home health agency Other (100%) Jun 30, 2011

Facilities with the same owner 69

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 69

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677715200000",
    "number": "1366523532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 LEE DEFOREST DRIVE",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21046",
            "telephone_number": "410-910-1500",
            "fax_number": "410-910-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 HOWARD HUGHES PKWY STE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891690946",
            "telephone_number": "702-560-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIM HEALTHCARE SERVICES, INC,",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A",
        "authorized_official_last_name": "KOWALCZYK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "410-910-1500"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NV",
            "license": "524HHA-12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3002095",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.