Individual provider Active NPI

Maxim A Pimkin, MD, PHD

  • Pediatrics Physician
  • Pittsburgh, PA
National Provider Identifier
1851686885
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MT199170 Issued in PA
Practice address
4401 Penn Ave
Pittsburgh, PA 15224-1334
Phone
(412) 692-5285
NPI assigned
Jun 17, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT199170 PA Primary

Addresses

Primary practice location

4401 Penn Ave
Pittsburgh, PA 15224-1334

Mailing address

4401 Penn Ave
Pittsburgh, PA 15224-1334
Phone (412) 692-5285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160620001183 MA Practitioner - Pediatric MedicinePractitioner - Hematology/Oncology 4385869460 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MT199170PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dana-Farber Cancer Institute, Inc. CurrentSince Jul 1, 2017 Accepting new patients
Children'S Hospital Pediatric Associates, Inc Pediatrics CurrentSince May 1, 2016 Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

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": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1851686885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 PENN AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241334",
            "telephone_number": "412-692-5285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 PENN AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241334",
            "telephone_number": "412-692-5285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIMKIN",
        "first_name": "MAXIM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-17",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT199170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.