Alexandra Dee Maxted Chantara, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

61380 Issued in TN

Practice address

1455 Union Ave
Memphis, TN 38104-6727

Phone

(901) 726-6655

Fax

(901) 726-9056

NPI assigned

Apr 12, 2016

Last updated

Jul 24, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Alexandra Dee Maxted Former name

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Dermatology

Education

University of Tennessee, HSC, College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memphis Dermatology Clinic PAGroup PAC ID 2264507524, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.26 of 100Reported as individual

Quality

90.51

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Memphis Dermatology Clinic PA

  • Dermatology Physician
  • Memphis, TN
  • NPI 1366416653
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1679937999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046727",
            "telephone_number": "901-726-6655",
            "fax_number": "901-726-9056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046727",
            "telephone_number": "901-726-6655",
            "fax_number": "901-726-9056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANTARA",
        "first_name": "ALEXANDRA",
        "middle_name": "DEE MAXTED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-12",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "61380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "MAXTED",
            "middle_name": "DEE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dominique Chang, M.D.
• Jenifer Chang, RDN
• Changing Life at Home Homecare Corp (Touching Hearts Homecare)
• Changing Minds Inc
• Changing the Criterion ABA Therapy
• Nicholas Suknarin Chantara, P.T.
• Rafael Alfonso Chaparro Jr., MD.
• Allison Rey Chapman, FAMILY NURSE PRACTIT
• Cathy M Chapman, M.D.
• Gregory Chapman

• Dermatology Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Dermatology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.