Michael J Maksimovich, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34005717A Issued in IN

Practice address

6314 Rucker Road Suite a
Indianapolis, IN 46220

Phone

(317) 250-4149

NPI assigned

May 9, 2009

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Indiana University Health Care Associates, Inc

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1902032832
  Medicare reassignment NPD
• Michael Maksimovich LCSW LLC

  • Clinical Social Worker
  • Indianapolis, IN
  • NPI 1033890157
  NPD Authorized official
• Methodist Medical Group Physicians Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1285673616
  NPD (past)
• University Medical Diagnostic Associates, Inc.

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1861441537
  NPD (past)

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

{
    "created_epoch": "1241827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1649404377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6314 RUCKER ROAD SUITE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46220",
            "telephone_number": "317-250-4149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6314 RUCKER ROAD SUITE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46220",
            "telephone_number": "317-250-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKSIMOVICH",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-09",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005717A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE II NPI",
            "identifier": "1033890157",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sunil Kumar Makineni
• Kotaro Makino, MD
• Shaniece Makori
• Richard L Makowiec, M.D.
• Bobette Makoyi, CRNA
• Robert Michael Malachowski, M.D.
• Irwin Bernard Malament, D.P.M.
• Alyssa Nicole Malander, LCSW
• Carly Malchow, RBT
• Jennfier Malcolm, PNP

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; 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.