Maximo James Marin Jr., M.D.

Primary specialty

Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X

License

ME151533 Issued in FL

Practice address

5841 S Maryland Ave
MC 3083, Department of Pathology
Chicago, IL 60637-1447

Phone

(773) 834-7708

NPI assigned

Jun 21, 2013

Last updated

Jun 25, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: mmarin532165@direct.shands.ufl.edu

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.

• Florida Clinical Practice Association Inc

  dba UF Health Physicians

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  Medicare reassignment

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1629417886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "address_2": "BOX 100275",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32610",
            "telephone_number": "352-273-7839",
            "fax_number": "352-273-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "address_2": "MC 3083, DEPARTMENT OF PATHOLOGY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "773-834-7708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326101447",
            "country_code": "US",
            "telephone_number": "352-273-7839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARIN",
        "first_name": "MAXIMO",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-21",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036142195",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "FL",
            "license": "ME151533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra L Marin, LCSW
• Dajana Marin, RD
• Jonathan J Marin
• Lorell Marin, DT, MST
• Mara Clare Marin, LPC
• Rebecca Marin, MD
• Sara Marin, MD
• Sean Alden Marin
• Stephanie Marin
• Marina Kuznetsova MD SC

• Clinical Pathology/Laboratory Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Pathology/Laboratory Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.