Maxim Healthcare Services, Inc.

Organization Active NPI Home Health Agency · Oxnard, CA

NPI 1417065699 · NPPES record last updated May 8, 2024

Key facts

NPI
1417065699
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
License
050000590 (CA)
Legal business name
MAXIM HEALTHCARE SERVICES, INC.
Practice address
300 E Esplanade Dr Ste 1500
Oxnard, CA 93036-0244
Phone
(805) 278-4593
Fax
(805) 278-8853
NPI assigned
Aug 28, 2006
Organization subpart
No

Authorized official

Name
David Kowalczyk
Title
Executive VP of Finance
Phone
(410) 910-1500

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Facilities with the same owner 69

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

View all 69

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare Care Compare: Home health agency

Listed as
Maxim Healthcare Services Inc CCN 058352
Ownership
Proprietary
Certified
Feb 9, 2007
Medicare certification status
Active (Provider of Services file)
Services
Nursing, Medical social, Home health aide, Physical therapy

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Home health agency certification: CCN 058352

Legal name
MAXIM HEALTHCARE SERVICES INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 9, 2007
Last certification
Dec 13, 2018
Ownership / control type
Proprietary
Organization structure
Corporation · Proprietary
Incorporated
Sep 2, 1988 in MD
Enrollment address
500 E Esplanade Dr
Ste 660
Oxnard, CA 93036-0530

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
For-profit
Other Jan 30, 2006
Joseph W Marshall
Individual
Corporate Director
Board Member
Jul 1, 2017
Randall D Sones
Individual
Corporate Director
Board Member
Aug 25, 2009
Jarrod L Depriest
Individual
Corporate Officer
President
Jan 1, 2022
Matthew Sticklin
Individual
Corporate Officer
Cfo
Aug 29, 2022
David S. Kowalczyk
Individual
W-2 Managing Employee
Regional VP Finance
Oct 15, 2012
Toni-Jean L Friedman
Individual
Corporate Officer
VP/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%
Oak Investment Trust II
Organization · Tampa, FL
5% Or Greater Indirect Ownership Interest Mar 18, 2019 39.35%
James C Davis
Individual
Corporate Director
Board 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 Director
Board Member
Apr 21, 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 Inc
Pueblo, CO · CCN 067413
Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services Inc
Poland, OH · CCN 368042
Home health agency Other (100%) Jan 9, 2006
Maxim Healthcare Services Inc
Pittsburgh, PA · CCN 397783
Home health agency Other (100%) Jan 9, 2006
Maxim Healthcare Services Inc
Tucson, AZ · CCN 037228
Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services Inc
Sandy, UT · CCN 467212
Home health agency Other Jan 9, 2006
Maxim Healthcare Services Inc
Bedford, NH · CCN 307085
Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services Inc
Harrisburg, 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 Inc
Plains, PA · CCN 398016
Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services Inc
Phoenix, AZ · CCN 037242
Home health agency Other (100%) Apr 25, 2006
Maxim Healthcare Services Inc
Madison, WI · CCN 527290
Home health agency Other Jan 9, 2006
Maxim Healthcare Services Inc
Canton, OH · CCN 368007
Home health agency Other (100%) Jan 9, 2006
Maxim Healthcare Services Inc
Toledo, OH · CCN 367799
Home health agency Other Jan 9, 2006
Maxim Healthcare Services Inc
Reno, NV · CCN 297049
Home health agency Other (100%) Jan 9, 2006
Maxim Healthcare Services Inc
Anchorage, AK · CCN 027032
Home health agency Other Jan 9, 2006
Maxim Healthcare Services Inc
Fresno, CA · CCN 058323
Home health agency Other Jan 9, 2006
Maxim Healthcare Services Inc
Las Vegas, NV · CCN 297085
Home health agency Other (100%) Sep 2, 1988
Maxim Healthcare Services Inc
Allentown, PA · CCN 398065
Home health agency Other (100%) Jun 1, 2007
Maxim Healthcare Services Inc
Colorado Springs, CO · CCN 067325
Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services Inc
La Junta, CO · CCN 067466
Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services Inc
San Luis Obispo, CA · CCN 059129
Home health agency Other (100%) Dec 4, 2009
Maxim Healthcare Services Inc
Roseville, CA · CCN 059117
Home health agency Operational/Managerial Control (100%) Jan 1, 2009
Maxim Healthcare Services Inc
York, PA · CCN 398132
Home health agency Other (100%) Apr 28, 2010
Maxim Healthcare Services Inc
Evansville, IN · CCN 157680
Home health agency Other (100%) Jun 30, 2011
Maxim Healthcare Services Inc
Crown Point, IN · CCN 157679
Home health agency Other (100%) Jun 30, 2011
Maxim Healthcare Services Inc
Los Angeles, CA · CCN 053198
Home health agency Other (100%) Jun 30, 2011

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20051003000244 CA Part a Provider - Home Health Agency 1658288410 Practice locations: Oxnard, CA

National Provider Directory

Tax ID family
Maxim Healthcare Servise (337 organizations share this tax ID)

Locations

300 E Esplanade Dr
Ste 1500
Oxnard, CA 93036
Phone (805) 278-4593

500 E Esplanade Dr
Ste 300
Oxnard, CA 93036

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 050000590 CA Yes

Addresses

Primary practice location

300 E Esplanade Dr Ste 1500
Oxnard, CA 93036-0244

Mailing address

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

Other providers in Oxnard, CA

All providers in Oxnard, CA · Home Health Agency in California

Sources for this page

Verify at the official NPI Registry.