NPIMap

Organization Active NPI

Maksam Healthcare LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Dover, DE
National Provider Identifier
1699529198
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MAKSAM HEALTHCARE LLC
Practice address
283 N Dupont Hwy Ste C
Dover, DE 19901-7532
Phone
(302) 217-6618
NPI assigned
Apr 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Authorized official

Name
Makesa A Toure, PMHNP-BCNPI 1891418901
Title
Owner
Phone
(302) 217-6618

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Multi-Specialty Clinic/Center 261QM1300X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

283 N Dupont Hwy Ste C
Dover, DE 19901-7532

Mailing address

283 N Dupont Hwy Ste C
Dover, DE 19901-7532
Phone (302) 217-6618

Other names 1

  • Maksam Health & Wellness Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD, PA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20240513001231 DE Part B Supplier - Clinic/Group Practice 5698116374 Receives reassigned benefits from 2 practitioners
Practice locations: Dover, DE
O20250310001787 MD Part B Supplier - Clinic/Group Practice 5698116374 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD
O20250310003151 PA Part B Supplier - Clinic/Group Practice 5698116374 Receives reassigned benefits from 1 practitioner
Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory

Locations

283 N DuPont Hwy
Ste C
Dover, DE 19901
Phone (302) 217-6618

7003 Elmwood Ave
Philadelphia, PA 19142
Phone (302) 269-0002

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1712880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724976000000",
    "number": "1699529198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "283 N DUPONT HWY STE C",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199017532",
            "telephone_number": "302-217-6618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 N DUPONT HWY STE C",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199017532",
            "telephone_number": "302-217-6618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAKSAM HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-12",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A",
        "authorized_official_last_name": "TOURE",
        "authorized_official_first_name": "MAKESA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-217-6618",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maksam Health & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maksam Health & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dover, DE

Sources for this page

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

Verify at the official NPI Registry.