Nicole Prestiano Maksymiw, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

054258 Issued in CT

Practice address

324 Elm St Ste 203a
Monroe, CT 06468-2282

Phone

(203) 212-9959

Fax

(203) 646-6534

NPI assigned

Jun 13, 2012

Last updated

Nov 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Nicole Ann Prestiano Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 7, 2025 through Jan 7, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15933/brand/1/csg/1/fhir/r4
• Direct secure messaging: nicole.maksymiw.1@15700.direct.athenahealth.com

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.

• Primary Health of Connecticut PLLC

  dba Primary Health CT

  • Primary Care Clinic/Center
  • Monroe, CT
  • NPI 1477311413
  NPD Authorized official
• Susan N Grammatico DNP FNP LLC

  dba Heartwood

  • Family Nurse Practitioner
  • New Milford, CT
  • NPI 1538053400
  NPD
• A. Keith Barton, PHD, PC

  • Clinical Psychologist
  • New Milford, CT
  • NPI 1154840718
  NPD (past)

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732924800000",
    "number": "1679835748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 ELM ST STE 203A",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064682282",
            "telephone_number": "203-212-9959",
            "fax_number": "203-646-6534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 ELM ST STE 203A",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064682282",
            "telephone_number": "203-212-9959",
            "fax_number": "203-646-6534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKSYMIW",
        "first_name": "NICOLE",
        "middle_name": "PRESTIANO",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2024-11-30",
        "certification_date": "2024-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "054258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "PRESTIANO",
            "middle_name": "ANN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Linda S. Luongo, LMFT
• Laurie Ann Lustiber, M.S., CCC-SP
• Maggie McCaffrey, LLC
• Main Street Counseling, LLC
• Judith Major, MD
• Brittany Man, BCBA, LBA
• Victoria Mao
• Melita Marchese, L.P.C.
• Bethanie Markowski, APRN
• Maverick Marrin, DC

• Internal Medicine Physician in Monroe, CT
• Providers in Monroe, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.