Maximillian Shmidheiser, PSYD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Practice address

411 Shortridge Dr
Wynnewood, PA 19096-1608

Phone

(215) 704-6003

NPI assigned

Aug 15, 2008

Sex

Male

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2022 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1477709830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 SHORTRIDGE DR",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190961608",
            "telephone_number": "215-704-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 SHORTRIDGE DR",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190961608",
            "telephone_number": "215-704-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHMIDHEISER",
        "first_name": "MAXIMILLIAN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-15",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Shepard, MD
• Jennifer Beth Sherwood, MD
• Aarti Lothe Shevade, M.D.,
• Vikas Anand Shevade, M.D.
• Debika Biswal Shinohara, MD
• Sachin Lal Shrestha, M.D.
• Jayalakshmi Shyamalan, MD
• Cathy Si, PA-C
• Aqeel Ahmed Siddiqui, MD
• Bernita Sidhu, MD

• Clinical Neuropsychologist in Wynnewood, PA
• Providers in Wynnewood, PA by specialty
• Clinical Neuropsychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.