Andrew Maxwell, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

32010 Issued in IA

Practice address

1 Edmundson PL
Council Bluffs, IA 51503-4658

Phone

(712) 396-4310

Fax

(712) 396-7069

NPI assigned

Aug 29, 2006

Last updated

Dec 16, 2013By 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 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA

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

Pediatric Medicine

Education

University of Nebraska College of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andrew.maxwell@direct.nmhs.org

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.

• Physicians Clinic Inc

  dba Methodist Physicians Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1821049156

  IA, Pediatrics

  Medicare reassignment Care Compare group NPD
• Nebraska Methodist Hospital

  dba Methodist Hospital

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1427147883
  NPD
• Alegent Health Bergan Mercy Health System

  dba CHI Health Mercy Council Bluffs

  • General Acute Care Hospital
  • Council Bluffs, IA
  • NPI 1265517759
  NPD (past)
• Boone County Hospital

  • Critical Access Hospital
  • Boone, IA
  • NPI 1467434225
  NPD (past)
• Jennie Edmundson Memorial Hospital

  dba Methodist Jennie Edmundson

  • General Acute Care Hospital
  • Council Bluffs, IA
  • NPI 1457448755
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387152000000",
    "number": "1922116789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EDMUNDSON PL",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034658",
            "telephone_number": "712-396-4310",
            "fax_number": "712-396-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2013-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "20636",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "32010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731712",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922116789",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelli Sue Matheny, BCBA
• Bonita Lee Mathiasen
• Jeffrey Bernard Mathiasen
• Richard Oliver Matland, MSW, LISW
• Rebecca Max
• Barbara Lynn Maxwell, LMSW
• Cody Maxwell
• Kristin M. Maxwell, PA-C
• Riley Kay Maxwell
• May Medical, Inc.

• Pediatrics Physician in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Pediatrics Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2013; 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.