Kristin M. Maxwell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

113030 Issued in IA

Practice address

800 Mercy Dr
Council Bluffs, IA 51503-3128

Phone

(402) 717-9800

NPI assigned

Feb 8, 2021

Last updated

Apr 14, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Kristin M. Pilakowski Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NE, IA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060
• CHI Health Immanuel Hospital, Omaha, NE, CCN 280081
• The Nebraska Medical Center Hospital, Omaha, NE, CCN 280013

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmaxwell535363@direct.nebraskamed.com
• Direct secure messaging: kpilakowski106588@stormontvaildirect.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.

• Alegent Creighton Clinic

  dba CHI Health Clinic

  • Family Medicine Physician
  • Council Bluffs, IA
  • NPI 1598811069
  Medicare reassignment Care Compare group
• Unmc Physicians

  • Multi-Specialty Clinic/Center
  • Omaha, NE
  • NPI 1417912114
  Medicare reassignment NPD
• Alegent Creighton Clinic

  dba CHI Health Clinic

  • Internal Medicine Physician
  • Omaha, NE
  • NPI 1518227859
  NPD
• Cotton-Oneil Clinic Endoscopy Center Rvoc TR

  dba Cotton O'Neil Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • Topeka, KS
  • NPI 1033246459
  NPD (past)
• Stormont-Vail Healthcare Inc

  • Clinical Medical Laboratory
  • Topeka, KS
  • NPI 1194234310
  NPD (past)

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

• Alegent Health Bergan Mercy Health System

  dba Lasting Hope Recovery Center

  • Psychiatric Hospital Unit
  • Omaha, NE
  • NPI 1396969499
  Care Compare affiliation
• Alegent Health Bergan Mercy Health System

  dba CHI Health Creighton University Medical Center-Bergan Mercy

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1508941097
  Care Compare affiliation
• Alegent Health Immanuel Medical Center

  dba CHI Health Immanuel

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1912085184
  Care Compare affiliation
• The Nebraska Medical Center

  dba The Nebraska Medical Center - Nebraska Medicine

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1356307581
  Care Compare affiliation

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1619569936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MERCY DR",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515033128",
            "telephone_number": "402-717-9800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 SW 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Topeka",
            "state": "KS",
            "postal_code": "666041353",
            "country_code": "US",
            "telephone_number": "785-354-4800",
            "fax_number": "785-270-4877",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7710 Mercy Rd Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681242323",
            "country_code": "US",
            "telephone_number": "402-717-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "KRISTIN",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-08",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2538",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02442",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "113030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpilakowski106588@stormontvaildirect.org",
            "affiliation": "Y",
            "endpointDescription": "SVH Secure messaging",
            "affiliationName": "COTTON-O'NEIL CLINIC REVOCABLE TRUST",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1500 SW 10th Ave",
            "city": "Topeka",
            "state": "KS",
            "country_code": "US",
            "postal_code": "666041353",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpilakowski106588@stormontvaildirect.org",
            "affiliation": "Y",
            "endpointDescription": "SVH Secure Messaging",
            "affiliationName": "STORMONT-VAIL HEALTHCARE INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1500 SW 10th Ave",
            "city": "Topeka",
            "state": "KS",
            "country_code": "US",
            "postal_code": "666041353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "PILAKOWSKI",
            "middle_name": "M.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard Oliver Matland, MSW, LISW
• Rebecca Max
• Andrew Maxwell, M.D.
• Barbara Lynn Maxwell, LMSW
• Cody Maxwell
• Riley Kay Maxwell
• May Medical, Inc.
• Susan Dawn Mayberry
• Latois Nicole Mayfield
• Diane Lyn Mayhew, OTR/L

• Physician Assistant in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; 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.