NPIMap

Organization Active NPI

Maxim Healthcare Services, Inc.

  • Home Health Agency
  • Fort Lauderdale, FL
National Provider Identifier
1902912512
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
20674096 Issued in FL
Legal business name
MAXIM HEALTHCARE SERVICES, INC.
Practice address
6301 NW 5TH Way
Suite 5010
Ft Lauderdale, FL 33309-6131
Phone
(954) 977-9958
NPI assigned
Aug 23, 2006
Last updated
Mar 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Authorized official

Name
David Kowalczyk
Title
Executive VP of Finance
Phone
(410) 910-1730

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 20674096 FL Primary
Respite Care 385H00000X
In Home Supportive Care Agency 253Z00000X

Addresses

Primary practice location

6301 NW 5TH Way
Suite 5010
Ft Lauderdale, FL 33309-6131

Mailing address

7227 Lee Deforest Dr
Columbia, MD 21046-3236

Other identifiers 6

IdentifierTypeStateIssuer
682444200MedicaidFL
001135800MedicaidFL
672823596MedicaidFL
650242301MedicaidFL
650242300MedicaidFL
650242379MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902912512. Details of each certification follow.

Home health agency certification: CCN 10K029

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
MAXIM HEALTHCARE SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 13, 2002
Last certification
Jul 14, 2017
Ownership / control type
Proprietary
Facility address
6301 NW 5TH Way Ste 5010
Fort Lauderdale, FL 33309

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0901238Maxim Healthcare Services Inc6301 NW 5TH Way, Fort Lauderdale, FL 33309Certificate of waiverMay 18, 2027

National Provider Directory

National Provider Directory
Tax ID family
Maxim Healthcare Servise339 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741564800000",
    "number": "1902912512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 LEE DEFOREST DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 NW 5TH WAY",
            "address_2": "SUITE 5010",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333096131",
            "telephone_number": "954-977-9958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIM HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A",
        "authorized_official_last_name": "KOWALCZYK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE VP OF FINANCE",
        "authorized_official_telephone_number": "410-910-1730"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "20674096",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "682444200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001135800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "672823596",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "650242301",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "650242300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "650242379",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.