Jessica Maxwell, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

035354-01 Issued in NY

Practice address

100 College Pkwy Ste 101
Williamsville, NY 14221-6885

Phone

(716) 362-1552

NPI assigned

Apr 27, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Diversified Services for Occupational Therapy Physical TherGroup PAC ID 0143204917, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Diversified Services for Occupational Therapy, Physical Ther

  • Audiologist
  • Kenmore, NY
  • NPI 1447283882
  Medicare reassignment Care Compare group NPD
• Diversified Services for Occupational Therapy, Physical Therapy, Speec

  • Physical Medicine & Rehabilitation Physician
  • Kenmore, NY
  • NPI 1417576547
  NPD

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1407438609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 DELAWARE AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142172309",
            "telephone_number": "716-871-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COLLEGE PKWY STE 101",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216885",
            "telephone_number": "716-362-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "JESSICA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "035354-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George E Matthews, MD
• Albert Matuch, LPN
• Sharon Mauck
• Nicole Marie Mauro
• Deborah Maxwell, NP
• Brian James May, RPA C
• Maya Devi Srivastava MD PH DPC
• Leah Maynard, PA-C
• Christopher Paul Mazur, PHARMD
• Allison Mazurek, PA-C

• Physical Therapist in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.