Max H Hines, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP4509 Issued in MN

Practice address

3304 Shepherd Hills Dr
Bloomington, MN 55431-1541

Phone

(952) 835-0372

NPI assigned

Jun 23, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Clinical Psychologist

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Puget Sound Psychiatric Center PSGroup PAC ID 4688766066, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Puget Sound Psychiatric Center, PS

  dba PSPC

  • Psychiatry Physician
  • Bothell, WA
  • NPI 1114254729
  Medicare reassignment Care Compare group NPD
• Associated Clinic of Psychology Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Louis Park, MN
  • NPI 1588741292
  NPD (past)
• Neighborhood Involvement Program

  • Counselor
  • Minneapolis, MN
  • NPI 1912914037
  NPD (past)
• Oak Ridge Center PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Apple Valley, MN
  • NPI 1730247578
  NPD (past)

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811993983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3304 SHEPHERD HILLS DR",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554311541",
            "telephone_number": "952-835-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3304 SHEPHERD HILLS DR",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554311541",
            "telephone_number": "952-835-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINES",
        "first_name": "MAX",
        "middle_name": "H",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP4509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Rose Hiller
• Fardowza Hilowle
• Hilsa Health Services Inc
• Walter Allen Hinck, M.D.
• Elizabeth A Hines, DPT, ATC
• Dina Marie Hirsch, OTR
• John Thomas Hirsch, DO
• Abdinajib Hussein Hirsi
• Aden Hassan Hirsi
• Ayan Awale Hirsi

• Psychologist in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Psychologist in Minnesota

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.