Ryan Maxwell, DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

036.144123 Issued in IL

Practice address

2400 N Rockton Ave
Rockford, IL 61103-3655

Phone

(815) 971-5000

NPI assigned

Feb 23, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY, IL2 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

Philadelphia College of Osteopathic Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rockford Health PhysiciansGroup PAC ID 2567374036, 520 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Javon Bea Hospital Hospital, Rockford, IL, CCN 140239

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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.

• Rockford Health Physicians

  • Multi-Specialty Clinic/Center
  • Rockford, IL
  • NPI 1043242886
  Medicare reassignment Care Compare group NPD
• Premier Anesthesia of New York, P.C.

  • Anesthesiology Physician
  • Saranac Lake, NY
  • NPI 1063658961
  Medicare reassignment NPD
• RMH Pathologists, LTD

  • Anatomic Pathology Physician
  • Rockford, IL
  • NPI 1184671992
  NPD
• Premier Anesthesia of Florida LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1790330694
  NPD (past)

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

• Javon Bea Hospital

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1629118609
  Care Compare affiliation

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1659511202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 OXFORD RD",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194464763",
            "telephone_number": "215-527-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N ROCKTON AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033655",
            "telephone_number": "815-971-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Lancaster Ave",
            "address_purpose": "LOCATION",
            "city": "Wynnewood",
            "state": "PA",
            "postal_code": "190963450",
            "country_code": "US",
            "telephone_number": "610-645-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "RPM Med Solutions LLC",
            "address_2": "101 Oxford Rd",
            "address_purpose": "LOCATION",
            "city": "Lansdale",
            "state": "PA",
            "postal_code": "194464763",
            "country_code": "US",
            "telephone_number": "215-527-0571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8201 E Riverside Blvd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611142300",
            "country_code": "US",
            "telephone_number": "815-971-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-23",
        "last_updated": "2022-07-21",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "OS015922",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "288918",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036.144123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036144123",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102723767",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0308137",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659511202",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William S Mattox, APRN, CNP
• Charles W Matty, DDS
• Matthew Matulle, PHARM.D.
• Maxim Healthcare Services, Inc.
• Timea Maxim, MD
• Annette May, MSW, LSW, CAPSW
• Jacqueline G May, NP
• Deana M. Mayer, APN, CNP
• Erika Mayer, RDN, LDN
• Jennifer Lynn Mayer, PHARMD

• Anesthesiology Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Anesthesiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.