Individual provider Active NPI

Stefan T Maksymiw, PT

  • Physical Therapist
  • Holly Springs, NC
National Provider Identifier
1386675148
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P9789 Issued in NC
Practice address
781 Avent Ferry Rd Ste 110
Holly Springs, NC 27540-7776
Phone
(919) 781-4060
Fax
(919) 781-5246
NPI assigned
Jul 6, 2006
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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 P9789 NC Primary

Addresses

Primary practice location

781 Avent Ferry Rd Ste 110
Holly Springs, NC 27540-7776

Mailing address

3001 Edwards Mill Rd # 200
Raleigh, NC 27612-5243
Phone (919) 781-4060

Other identifiers 1

IdentifierTypeStateIssuer
079PPOtherNCBCBSNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050328000079 NC Practitioner - Physical Therapist in Private Practice 9335195916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Buffalo School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raleigh Orthopaedic Clinic PAGroup PAC ID 9032012638, 125 clinicians

Practice addresses (Care Compare)

1325 Timber Dr E
Garner, NC 27529-6924
Phone (919) 781-5600

781 Avent Ferry Rd
Suite 110
Holly Springs, NC 27540-7776
Phone (919) 781-5600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9789NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Orthopaedic Clinic PA CurrentSince Nov 15, 2010 Accepting new patients
Avante Physical Therapy Past Accepting new patients
Team Care Physical Therapy PastSince May 29, 2020 Accepting new patients
Team Care Manual & Physical Therapy Company Inc Physical Therapist PastSince Jul 1, 2001 Accepting new patients
Brown Orthopaedic Surgery & Sports Medicine Center, P.a. Past Accepting new patients
Raleigh Orthopaedic Pharmacy PastSince May 9, 2021 Accepting new patients

Locations

222 Ashville Ave
Ste 20
Cary, NC 27518
Phone (919) 235-0616

1325 Timber Dr E
Garner, NC 27529
Phone (919) 863-6991

781 Avent Ferry Rd
Ste 110
Holly Springs, NC 27540
Phone (919) 645-1411

3001 Edwards Mill Rd
#200
Raleigh, NC 27612
Phone (919) 863-6853

3515 Glenwood Ave
Raleigh, NC 27612
Phone 91978156006856

Organizations & group practices 6

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1386675148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 EDWARDS MILL RD # 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125243",
            "telephone_number": "919-781-4060",
            "fax_number": "919-781-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 AVENT FERRY RD STE 110",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275407776",
            "telephone_number": "919-781-4060",
            "fax_number": "919-781-5246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKSYMIW",
        "first_name": "STEFAN",
        "middle_name": "T",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P9789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "079PP",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Springs, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; 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.