Individual provider Active NPI

Anita Maximin, PSY D

  • Clinical Psychologist
  • Cleveland, OH
National Provider Identifier
1689624330
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4432 Issued in OH
Practice address
18780 Bagley Rd Ste 108
Cleveland, OH 44130-3304
Phone
(440) 816-2330
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4432 OH Primary

Addresses

Primary practice location

18780 Bagley Rd Ste 108
Cleveland, OH 44130-3304

Mailing address

PO Box 638269
Cincinnati, OH 45263-8269

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20040319001363 OH Practitioner - Clinical Psychologist 3072403146 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Strongsville Psychological Services, Inc.Group PAC ID 5193740801, 10 clinicians

Practice addresses (Care Compare)

7370 Engle Rd
Middleburg Heights, OH 44130-3429
Phone (440) 234-9955

Merit-based Incentive Payment System (MIPS)

Final score
81.06 of 100Reported as group
Quality
63.56
Promoting interoperability
100
Improvement activities
40
Cost
73.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4432OHMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest General Medical Group Inc CurrentSince Nov 16, 2022 Accepting new patients
Outreach Professional Services Inc CurrentSince Oct 1, 2019 Accepting new patients
Strongsville Psychological Services, Inc. CurrentSince Aug 1, 1990 Accepting new patients
Outreach Professional Services, Inc CurrentSince Oct 1, 2019 Accepting new patients
Southwest General Medical Group Inc CurrentSince Nov 16, 2022 Accepting new patients

Locations

2322 E 22nd St
Ste 207
Cleveland, OH 44115
Phone (216) 363-2578

2475 E 22nd St
Ste 120
Cleveland, OH 44115
Phone (216) 367-9444

7370 Engle Rd
Middleburg Heights, OH 44130
Phone (440) 234-9955

7255 Old Oak Blvd
Ste C202
Middleburg Heights, OH 44130
Phone (440) 816-5390

18780 Bagley Rd
Ste 108
Middleburg Heights, OH 44130
Phone (440) 816-2330

Organizations & group practices 5

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1689624330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638269",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452638269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18780 BAGLEY RD STE 108",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441303304",
            "telephone_number": "440-816-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXIMIN",
        "first_name": "ANITA",
        "credential": "PSY D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "4432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.