Individual provider Active NPI

John E Maxa, M.D.

  • Anesthesiology Physician
  • Snellville, GA
National Provider Identifier
1487635090
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036225 Issued in GA
Practice address
1700 Medical Way
Snellville, GA 30078-2195
Phone
(770) 979-9996
Fax
(770) 979-1202
NPI assigned
Nov 10, 2005
Last updated
Jun 24, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036225 GA Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X 036225 GA

Addresses

Primary practice location

1700 Medical Way
Snellville, GA 30078-2195

Mailing address

PO Box 3559
Suwanee, GA 30024-0993
Phone (770) 979-9996

Other identifiers 1

IdentifierTypeStateIssuer
000657918EMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101008000328 GA Practitioner - Anesthesiology 0547452914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Emory University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Anesthesia Professionals, LLCGroup PAC ID 5496134348, 543 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 851-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Atlanta Anesthesia Professionals, LLC Anesthesiology CurrentSince Sep 1, 2022 Accepting new patients

Locations

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1487635090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3559",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300240993",
            "telephone_number": "770-979-9996",
            "fax_number": "770-979-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 MEDICAL WAY",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782195",
            "telephone_number": "770-979-9996",
            "fax_number": "770-979-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXA",
        "first_name": "JOHN",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "036225",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "GA",
            "license": "036225",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000657918E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.