Active NPI
Marcus Scott Maydew, MD
- Diagnostic Radiology Physician
- Offutt AFB, NE
National Provider Identifier
1619916269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 20043
- Practice address
- 2501 Capehart Rd
Offutt AFB, NE 68113-1043 - Phone
- (402) 295-7405
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 20043 | NE | Primary |
Addresses
Primary practice location
2501 Capehart Rd
Offutt AFB, NE 68113-1043
Mailing address
2501 Capehart Rd
Offutt AFB, NE 68113-1043
Phone (402) 295-7405
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20043 | NE | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creighton University | Past | Accepting new patients | |
| Creighton University | Past | Accepting new patients | |
| Alegent Creighton Clinic | Past | Accepting new patients | |
| Alegent Creighton Clinic | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Creighton Medical Associates
- Allergy & Immunology (Internal Medicine) Physician
- Omaha, NE
- NPI 1295777225
-
dba CHI Health Clinic
- Family Medicine Physician
- Council Bluffs, IA
- NPI 1598811069
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571616000000",
"number": "1619916269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2501 CAPEHART RD",
"city": "OFFUTT AFB",
"state": "NE",
"postal_code": "681131043",
"telephone_number": "402-295-7405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 CAPEHART RD",
"city": "OFFUTT AFB",
"state": "NE",
"postal_code": "681131043",
"telephone_number": "402-295-7405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYDEW",
"first_name": "MARCUS",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2019-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NE",
"license": "20043",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Offutt AFB, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.