Mark Raymond Maxon, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV0051831 Issued in NY

Practice address

720 University Ave
Ste 110
Syracuse, NY 13210-1702

Phone

(315) 425-0373

Fax

(315) 425-0373

NPI assigned

Jan 30, 2007

Last updated

Feb 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• National Eye Care, Inc

  • Optometrist
  • Fayetteville, NY
  • NPI 1427405133
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1851437479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 UNIVERSITY AVE",
            "address_2": "STE 110",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101702",
            "telephone_number": "315-425-0373",
            "fax_number": "315-425-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 UNIVERSITY AVE",
            "address_2": "STE 110",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101702",
            "telephone_number": "315-425-0373",
            "fax_number": "315-425-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXON",
        "first_name": "MARK",
        "middle_name": "RAYMOND",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV0051831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maxim Healthcare
• Maxim Healthcare Servise
• Maxim of New York, LLC
• Maxim of New York, LLC (Maxim Healthcare Services, Inc.)
• Angelina Marie Maxon, O.D.
• Iris Louise Maxwell, LPN
• Melinda L Maxwell, RN
• Adriana May, MD
• Kathryn Marie May, M.S.
• Amy Mayer, PMHNP-BC

• Optometrist in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.