Individual provider Active NPI

Sherri L. Maximiuk, PA

  • Medical Physician Assistant
  • Long Beach, CA
National Provider Identifier
1700936010
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA16079 Issued in CA
Practice address
2865 Atlantic Ave Ste 226
Long Beach, CA 90806-1723
Phone
(714) 926-8444
Fax
(714) 738-1352
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA16079 CA Primary

Addresses

Primary practice location

2865 Atlantic Ave Ste 226
Long Beach, CA 90806-1723

Mailing address

2865 Atlantic Ave Ste 226
Long Beach, CA 90806-1723
Phone (714) 926-8444

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
16079CAMDSpeech-Language Pathologist
PA16079CAMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1700936010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 ATLANTIC AVE STE 226",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061723",
            "telephone_number": "714-926-8444",
            "fax_number": "714-738-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 ATLANTIC AVE STE 226",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061723",
            "telephone_number": "714-926-8444",
            "fax_number": "714-738-1352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXIMIUK",
        "first_name": "SHERRI",
        "middle_name": "L.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA16079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.