Active NPI
Ivanna Natasha Maxson, MD
- Pediatric Critical Care Medicine Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- S2110
- Practice address
- 200 UCLA Medical PLZ Ste 265
Los Angeles, CA 90095-2351 - Phone
- (310) 825-0867
- Fax
- (310) 794-5066
- NPI assigned
- May 12, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Critical Care Medicine Physician | 2080P0203X | S2110 | TX | Primary |
Addresses
Primary practice location
200 UCLA Medical PLZ Ste 265
Los Angeles, CA 90095-2351
Mailing address
5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-5631
Other practice location 1
6651 Main St
Houston, TX 77030-2351
Phone (832) 824-1000
Other practice location 2
1 Baylor Plz # Bcm320
Houston, TX 77030-3411
Phone (713) 798-4780
Other practice location 3
11234 Anderson St
Loma Linda, CA 92354-2804
Phone (909) 558-6131
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Critical Care (Intensivists)
- Education
- Loma Linda University School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10833 Le Conte Ave
Los Angeles, CA 90095-3075
10833 Leconte Ave
Los Angeles, CA 90095-3075
Phone (310) 825-9124
757 Westwood PLZ
Los Angeles, CA 90095-8358
Phone (310) 825-8021
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S2110 | TX | MD | Pediatric Critical Care Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| UC Regents | Pediatric Critical Care Medicine | Current | Accepting new patients |
Locations
200 UCLA Medical Plz
Ste 265
Los Angeles, CA 90095
Phone (310) 206-2429
File 2939
Los Angeles, CA 90074
Phone (310) 794-6596
5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200
10833 Le Conte Ave
#12311
Los Angeles, CA 90095
Phone (310) 825-9124
892 Aerovista Pl
Ste 210
San Luis Obispo, CA 93401
Phone (805) 549-8023
215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693180800000",
"number": "1821444571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD STE 400",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455631",
"telephone_number": "310-301-5631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 UCLA MEDICAL PLZ STE 265",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900952351",
"telephone_number": "310-825-0867",
"fax_number": "310-794-5066"
}
],
"practiceLocations": [
{
"address_1": "6651 Main St",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770302351",
"country_code": "US",
"telephone_number": "832-824-1000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Baylor Plz # Bcm320",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770303411",
"country_code": "US",
"telephone_number": "713-798-4780",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11234 Anderson St",
"address_purpose": "LOCATION",
"city": "Loma Linda",
"state": "CA",
"postal_code": "923542804",
"country_code": "US",
"telephone_number": "909-558-6131",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAXSON",
"first_name": "IVANNA",
"middle_name": "NATASHA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-12",
"last_updated": "2023-08-28",
"certification_date": "2023-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "TX",
"license": "S2110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.