Individual provider Active NPI

Max Patrick Livingston, PA-C

  • Physician Assistant
  • Waterford, MI
National Provider Identifier
1679430060
Registry record updated Jun 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601013887 Issued in MI
Practice address
2665 Elizabeth Lake Rd
Waterford, MI 48328-3277
Phone
(248) 681-9541
NPI assigned
Jan 7, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601013887 MI Primary

Addresses

Primary practice location

2665 Elizabeth Lake Rd
Waterford, MI 48328-3277

Mailing address

2665 Elizabeth Lake Rd
Waterford, MI 48328-3277
Phone (248) 681-9541

Other practice location 1

39201 7 Mile Rd # 140
Livonia, MI 48152-1079
Phone (248) 681-9541

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5601013887MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cory J Rubin MD PC PastSince Aug 1, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1767744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780790400000",
    "number": "1679430060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 ELIZABETH LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283277",
            "telephone_number": "248-681-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 ELIZABETH LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283277",
            "telephone_number": "248-681-9541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39201 7 Mile Rd # 140",
            "address_purpose": "LOCATION",
            "city": "Livonia",
            "state": "MI",
            "postal_code": "481521079",
            "country_code": "US",
            "telephone_number": "248-681-9541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIVINGSTON",
        "first_name": "MAX",
        "middle_name": "PATRICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-07",
        "last_updated": "2026-06-07",
        "certification_date": "2026-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601013887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.