Maxwell S Maccollum III, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

18546 Issued in AZ

Practice address

10450 W McDowell Rd
Ste 102
Avondale, AZ 85392-4802

Phone

(623) 846-1746

Fax

(623) 846-0993

NPI assigned

Aug 29, 2005

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

Other identifiers 2

Other names 1

• M.S. Maccollum III Other name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Orthopedic Surgery

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopedic Specialists of North America PLLCGroup PAC ID 7719014505, 310 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Orthopedic Specialists of North America, PLLC

  • Orthopaedic Surgery Physician
  • Phoenix, AZ
  • NPI 1770812828

  AZ, Orthopaedic Surgery

  Medicare reassignment NPD
• Orthopedic Specialists of North America PLLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Gilbert, AZ
  • NPI 1508337213

  Orthopaedic Surgery

  NPD
• Orthopedic Specialists of North America, PLLC

  • Orthopaedic Surgery Physician
  • Gilbert, AZ
  • NPI 1962292870

  Orthopaedic Surgery

  NPD
• Canyon Orthopaedic Surgeons, a Division of Osna, PLLC

  • Orthopaedic Surgery Physician
  • Peoria, AZ
  • NPI 1164507190

  Orthopaedic Surgery

  NPD (past)

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1922091503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80217",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850600217",
            "telephone_number": "602-385-2115",
            "fax_number": "480-418-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 W MCDOWELL RD",
            "address_2": "STE 102",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853924802",
            "telephone_number": "623-846-1746",
            "fax_number": "623-846-0993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6760 W Thunderbird Rd Ste E110",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853815027",
            "country_code": "US",
            "telephone_number": "602-648-5444",
            "fax_number": "602-772-3801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACCOLLUM",
        "first_name": "MAXWELL",
        "middle_name": "S",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "18546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286642",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3Z3988",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "M.S.",
            "last_name": "MACCOLLUM",
            "suffix": "III",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Avondale, AZ
• Orthopaedic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.

Verify at the official NPI Registry.