Jacob Ross Maxwell, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

DO166199 Issued in OR

Practice address

400 NE Mother Joseph PL
Vancouver, WA 98664-3200

Phone

(360) 828-5396

Fax

(360) 828-5455

NPI assigned

Mar 30, 2010

Last updated

May 27, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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 OR, WA2 enrollments

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 2

Specialty

Anesthesiology

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PeacehealthGroup PAC ID 5890689293, 188 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peacehealth St John Medical Center Hospital, Longview, WA, CCN 500041

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmaxwell436430@direct.peacehealth.org
• Direct secure messaging: jrmaxwel@yourcarecommunity.org

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.

• Peacehealth

  dba St. John Medical Center - PeaceHealth Medical Group

  • Multi-Specialty Clinic/Center
  • Longview, WA
  • NPI 1720056187

  Anesthesiology

  Medicare reassignment Care Compare group NPD
• Columbia Anesthesia Group P S

  • Anesthesiology Physician
  • Vancouver, WA
  • NPI 1861448235

  OR

  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Washington - TCS

  • Anesthesiology Physician
  • Portland, OR
  • NPI 1649816380
  Medicare reassignment NPD
• Northwest Anesthesia Physicians PC

  • Anesthesiology Physician
  • Springfield, OR
  • NPI 1770531196
  Medicare reassignment NPD
• Oregon Anesthesiology Group PC

  • Anesthesiology Physician
  • Portland, OR
  • NPI 1477527786
  Medicare reassignment
• Oag Trauma Services LLC

  • Anesthesiology Physician
  • Portland, OR
  • NPI 1548669948
  NPD (past)

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

• Peacehealth

  dba St. John Medical Center

  • General Acute Care Hospital
  • Longview, WA
  • NPI 1073510277
  Care Compare affiliation

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1568787893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 NE 87TH AVE STE 210",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641988",
            "telephone_number": "360-828-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NE MOTHER JOSEPH PL",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643200",
            "telephone_number": "360-828-5396",
            "fax_number": "360-828-5455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2211 NE 139th St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986862742",
            "country_code": "US",
            "telephone_number": "360-828-5396",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1015 NW 22nd Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972103025",
            "country_code": "US",
            "telephone_number": "360-828-5396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "JACOB",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-30",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "DO166199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allora Maxey
• William R Maxie, LMT
• Maxim Healthcare Services, Inc.
• Heather Maxwell-Rychart
• Hanna Maxwell
• James R Maxwell, MA, LMFT, LMHC
• Janet Lee Maxwell, RC
• Veronica Maxwell
• Barbara Irene May, LE, LMT, MMT, NMT
• Bobby Louis May Jr.

• Anesthesiology Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Anesthesiology Physician in Washington

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