Active NPI
Gregory John Maksymowicz, MD
- Psychiatry Physician
- Austin, TX
National Provider Identifier
1811047202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- E1662
- Practice address
- 708 W 10TH St
Austin, TX 78701-2025 - Phone
- (512) 473-2996
- Fax
- (512) 473-2996
- NPI assigned
- Jan 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | E1662 | TX | Primary |
Addresses
Primary practice location
708 W 10TH St
Austin, TX 78701-2025
Mailing address
2002 Eastside Dr
Austin, TX 78704-4327
Phone (512) 473-2996
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E1662 | TX | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811047202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2002 EASTSIDE DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787044327",
"telephone_number": "512-473-2996",
"fax_number": "512-473-2996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "708 W 10TH ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787012025",
"telephone_number": "512-473-2996",
"fax_number": "512-473-2996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAKSYMOWICZ",
"first_name": "GREGORY",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "E1662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.