NPIMap

Individual provider Active NPI

Maxim Shaydakov, MD

  • Vascular Surgery Physician
  • York, PA
National Provider Identifier
1780118679
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD488318 Issued in PA
Practice address
30 Monument Rd Ste 1100
York, PA 17403-5024
Phone
(717) 851-6454
NPI assigned
Apr 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X MD488318 PA Primary

Addresses

Primary practice location

30 Monument Rd Ste 1100
York, PA 17403-5024

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Other practice location 1

2900 Carlisle Pike
New Oxford, PA 17350-8426
Phone (717) 851-8426

Other practice location 2

37 Monument Rd Ste 101
York, PA 17403-5023
Phone (717) 851-6454

Other practice location 3

1227 Baltimore St
Hanover, PA 17331-4406
Phone (717) 851-6454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250815004121 PA Practitioner - Vascular SurgeryPractitioner - General Surgery 1254600216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

25 Monument Rd
Suite 145
York, PA 17403-5060
Phone (717) 812-2480

Hospital & facility affiliations

  • Wellspan York Hospital Hospital, York, PA, CCN 390046
  • Gettysburg Hospital Hospital, Gettysburg, PA, CCN 390065
  • Wellspan Chambersburg Hospital Hospital, Chambersburg, PA, CCN 390151
  • Wellspan Good Samaritan Hospital Hospital, Lebanon, PA, CCN 390066

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Jul 28, 2025 Accepting new patients
Wellspan Medical Group CurrentSince Jul 28, 2025 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group Past Accepting new patients

Locations

1227 Baltimore St
Hanover, PA 17331
Phone (717) 646-4204

2900 Carlisle Pike
New Oxford, PA 17350
Phone (717) 624-5260

37 Monument Rd
#101
York, PA 17403
Phone (717) 812-4700

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

25 Monument Rd
Ste 145
York, PA 17403
Phone (717) 741-3449

30 Monument Rd
Ste 1100
York, PA 17403
Phone (717) 851-2441

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

Interoperability endpoints

  • Direct secure messaging: mshaydakov473811@wellspan.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1780118679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MONUMENT RD STE 1100",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174035024",
            "telephone_number": "717-851-6454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 Carlisle Pike",
            "address_purpose": "LOCATION",
            "city": "New Oxford",
            "state": "PA",
            "postal_code": "173508426",
            "country_code": "US",
            "telephone_number": "717-851-8426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "37 Monument Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174035023",
            "country_code": "US",
            "telephone_number": "717-851-6454",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1227 Baltimore St",
            "address_purpose": "LOCATION",
            "city": "Hanover",
            "state": "PA",
            "postal_code": "173314406",
            "country_code": "US",
            "telephone_number": "717-851-6454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAYDAKOV",
        "first_name": "MAXIM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-18",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD488318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.