Individual provider Active NPI

Max Martin Pistner, PA-S

  • Student in an Organized Health Care Education/Training Program
  • Portland, ME
National Provider Identifier
1821877424
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
716 Stevens Ave
Portland, ME 04103-2656
Phone
(207) 248-7881
NPI assigned
Sep 25, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X PA2931 ME
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

716 Stevens Ave
Portland, ME 04103-2656

Mailing address

35 Medical Center Pkwy
Augusta, ME 04330-8160
Phone (207) 252-5475

Other practice location 1

149 main street
Winthrop, ME 04364
Phone (207) 377-2111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250903002190 ME Practitioner - Physician Assistant 9436651130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mainegeneral Medical CenterGroup PAC ID 1254245715, 554 clinicians

Practice addresses (Care Compare)

149 N St
Waterville, ME 04901
Phone (207) 872-1000

Hospital & facility affiliations

  • Maine General Medical Center Hospital, Augusta, ME, CCN 200039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2931MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center Single Specialty CurrentSince Sep 22, 2025 Accepting new patients
Mainegeneral Medical Center CurrentSince Sep 22, 2025 Accepting new patients

Locations

35 Medical Center Pkwy
Augusta, ME 04330
Phone (207) 621-3639

149 North St
Waterville, ME 04901
Phone (207) 622-1959

149 Main St
Winthrop, ME 04364
Phone (207) 377-2111

Interoperability endpoints

  • Direct secure messaging: maxpistner@mgh.allscriptsdirect.net

Organizations & group practices 2

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": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1821877424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 MEDICAL CENTER PKWY",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043308160",
            "telephone_number": "207-252-5475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 STEVENS AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032656",
            "telephone_number": "207-248-7881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "149 main street",
            "address_purpose": "LOCATION",
            "city": "Winthrop",
            "state": "ME",
            "postal_code": "04364",
            "country_code": "US",
            "telephone_number": "207-377-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PISTNER",
        "first_name": "MAX",
        "middle_name": "MARTIN",
        "credential": "PA-S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-25",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "PA2931",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.