Organization Active NPI

Maxine Cappel Mayreis DC Dacs PC

  • Chiropractor
  • Locust Valley, NY
National Provider Identifier
1497807382
Registry record updated Apr 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MAXINE CAPPEL MAYREIS DC DACS PC
Practice address
480 Forest Ave Rear
Locust Valley, NY 11560-2151
Phone
(516) 759-7702
Fax
(516) 674-0572
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2018

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

Authorized official

Name
Dr. Maxine Ann Mayreis, DCNPI 1851450696
Title
Owner
Phone
(516) 759-7702

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

480 Forest Ave Rear
Locust Valley, NY 11560-2151

Mailing address

480 Forest Ave Rear
Locust Valley, NY 11560-2151
Phone (516) 759-7702

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041222000190 NY Part B Supplier - Clinic/Group Practice 9234197237 Receives reassigned benefits from 1 practitioner
Practice locations: Locust Valley, NY

National Provider Directory

National Provider Directory

Locations

480 Forest Ave
#M
Locust Valley, NY 11560

480 Forest Ave
Rear
Locust Valley, NY 11560
Phone (516) 759-7702

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523836800000",
    "number": "1497807382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 FOREST AVE REAR",
            "city": "LOCUST VALLEY",
            "state": "NY",
            "postal_code": "115602151",
            "telephone_number": "516-759-7702",
            "fax_number": "516-674-0572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 FOREST AVE REAR",
            "city": "LOCUST VALLEY",
            "state": "NY",
            "postal_code": "115602151",
            "telephone_number": "516-759-7702",
            "fax_number": "516-674-0572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXINE CAPPEL MAYREIS DC DACS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2018-04-16",
        "status": "A",
        "authorized_official_last_name": "MAYREIS",
        "authorized_official_first_name": "MAXINE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-759-7702",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Locust Valley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.