Individual provider Active NPI

Tanya Maria Maximoff, D.C.

  • Chiropractor
  • Madison, NJ
National Provider Identifier
1386762755
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00585000 Issued in NJ
Practice address
250 Main Street
Suite 6
Madison, NJ 07940
Phone
(973) 292-0222
Fax
(973) 236-0034
NPI assigned
Mar 26, 2007
Last updated
Sep 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00585000 NJ Primary

Addresses

Primary practice location

250 Main Street
Suite 6
Madison, NJ 07940

Mailing address

250 Main Street
Suite 6
Madison, NJ 07940
Phone (973) 292-0222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041005000783 NJ Practitioner - Chiropractic 3870552979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

250 Main St
Madison, NJ 07940-2237

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1386762755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 MAIN STREET",
            "address_2": "SUITE 6",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "07940",
            "telephone_number": "973-292-0222",
            "fax_number": "973-575-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MAIN STREET",
            "address_2": "SUITE 6",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "07940",
            "telephone_number": "973-292-0222",
            "fax_number": "973-236-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXIMOFF",
        "first_name": "TANYA",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00585000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; 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.