MAXIMILIAN JAMES SMITH (NPI# 1962791467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962791467 |
| Entity Type | Individual |
| Full Name | MAXIMILIAN JAMES SMITH |
| Credential | M.D. |
| Practice Address |
41 Mall Road Lahey Hospital & Medical Center Burlington MA 01805-0001 |
| Practice Telephone | 7817448170 |
| Practice Fax Number | 7817445232 |
| Mailing Telephone | 7817448170 |
| Mailing Fax Number | 7817445232 |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2018-06-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085N0700X |
Radiology Specialization: Neuroradiology |
266093 | MA | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
266093 | MA | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
57898 | CO | Allopathic & Osteopathic Physicians |
| N | 2085D0003X |
Radiology Specialization: Diagnostic Neuroimaging |
266093 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 16317513 | 05 | |
| CO | MEDICARE PIN | 559221ZLJ3 | 01 |
| KS | MEDICARE PIN | KA3249086 | 01 |
| NE | MEDICARE PIN | NA1214108 | 01 |
| KS | MEDICARE PIN | 111257095 | 01 |
| CO | MEDICARE PIN | 559221YQPG | 01 |
| CO | MEDICARE PIN | 559221YQ33 | 01 |
| HI | MEDICARE PIN | H109846 | 01 |
| CO | MEDICARE PIN | 559221YQN9 | 01 |
| NE | MEDICARE PIN | NA2517086 | 01 |
| HI | MEDICARE PIN | H109845 | 01 |
| HI | MEDICARE PIN | H109847 | 01 |
| NE | MEDICARE PIN | NA1215109 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 501 E Hampden Ave, Englewood, CO 801132702 | 3037619190 | 7208744462 |
| Street Address |
41 MALL ROAD LAHEY HOSPITAL & MEDICAL CENTER |
| City | BURLINGTON |
| State | MA |
| Zip Code | 01805-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750376380 | Darryl D Esakof | Internal Medicine | 41 Mall Road, Department of Cardiovascular Medicine, Lahey Clinic, Burlington, MA 01805 | 2005-09-20 |
| 1770109258 | Vivek Sinanan | Student in an Organized Health Care Education/Training Program | 41 Mall Road, Burlington, MA 01805 | 2020-06-22 |
| 1023671351 | Anne Marcia Woodbury | Nurse Anesthetist, Certified Registered | 41 Mall Road, Burlington, MA 01805 | 2019-04-22 |
| 1902385099 | Bridget Watts | Nurse Practitioner | 41 Mall Road, Burlington, MA 01805 | 2018-08-09 |
| 1710464300 | Lynn Breymer | Registered Nurse | 41 Mall Road, Lahey Clinic, Inc., Burlington, MA 01805-0001 | 2018-07-26 |
| 1154840130 | Melissa Ann Cucchi | Nurse Practitioner | 41 Mall Road, Lahey Hospital and Medical Center, Burlington, MA 01805-0001 | 2017-09-11 |
| 1386168532 | Kimberly Ann Kisil | Social Worker | 41 Mall Road, Burlington, MA 01803 | 2017-07-31 |
| 1942722939 | Ali Al Jabri | Student in an Organized Health Care Education/Training Program | 41 Mall Road, Burlington, MA 02155 | 2017-07-11 |
| 1881114197 | Markus Ricci | Student in an Organized Health Care Education/Training Program | 41 Mall Road, Burlington, MA 01805 | 2017-06-27 |
| 1902326200 | David Mintz | Student in an Organized Health Care Education/Training Program | 41 Mall Road, Graduate Medical Education, Burlington, MA 01805 | 2017-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750867909 | Natalie Teresa Dal'bo | Student in an Organized Health Care Education/Training Program | 41 Mall Road Office of Graduate Medical Education, Burlington, MA 01805 | 2018-07-11 |
| 1043710791 | Beth Israel Lahey Health Primary Care, Inc. | Urology | Lahey Institute of Urology, Beverly, 41 Mall Rd., Burlington, MA 01805 | 2018-02-20 |
| 1902240872 | Lloyd Jones Jr. | Student in an Organized Health Care Education/Training Program | 41 Mall Rd Department of Plastic Surgery, Burlington, MA 01805 | 2013-04-23 |
| 1508020470 | Russell Andrew Baur | Internal Medicine | Lahey Clinic Inc., 41 Mall Road, Burlington, MA 01805 | 2008-07-10 |
| 1356491237 | Jacob Magee Sands | Internal Medicine | 41 Burlington Mall Rd., Lahey Clinic, Burlington, MA 01805 | 2007-01-11 |
| 1588757108 | Richard Alan Wold | Nurse Anesthetist, Certified Registered | Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA 01805 | 2006-10-02 |
| 1841302387 | David M. Venesy | Internal Medicine | Lahey Clinic Cardiology -5 E, 41 Mall Road, Burlington, MA 01805 | 2006-08-31 |
| 1790750354 | Cara J. Foss | Nurse Practitioner | Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA 01805 | 2006-02-17 |
| 1225022155 | Laura Saluja | Internal Medicine | Lahey Clinic - General Internal Medicine, 41 Mall Road, Burlington, MA 01805 | 2005-09-07 |
| 1770588923 | Gene Wong | Radiology | 41 Mall Rd, Burlington, MA 01805 | 2005-06-15 |
| Find all providers in zip 01805 | ||||
| Taxonomy Code | 2085N0700X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Neuroradiology |
| A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205244993 | Emanuele Orru' | Radiology | Lahey Hospital & Medical Center, 41 Mall Road, Burlington, MA 01805-0001 | 2014-07-26 |
| 1063703791 | Reza Hakimelahi | Radiology | 41 Mall Rd, Burlington, MA 01805-2621 | 2011-04-28 |
| 1760707236 | Michael P. Bazylewicz | Radiology | 111 Colchester Ave, Uvm Medical Center - Dept. of Radiology, Burlington, VT 05401-1473 | 2010-03-28 |
| 1275762551 | Adam C. Ulano | Radiology | 111 Colchester Ave, Uvm Medical Center - Dept. of Radiology, Burlington, VT 05401-1473 | 2009-07-08 |
| 1184851917 | Bruno Passebon Soares | Radiology | 111 Colchester Ave, Main Campus, Mcclure, Level 1, Burlington, VT 05401 | 2009-06-19 |
| 1417009549 | Heather Nicole Burbank | Radiology | 111 Colchester Ave, Burlington, VT 05401-1473 | 2007-01-17 |
| 1417012360 | In Sup Choi | Radiology | Lahey Clinic, 41 Mall Rd, Burlington, MA 01805-0001 | 2006-12-22 |
| 1447350442 | Philip D. Kousoubris | Radiology | Lahey Clinic, 41 Mall Road, Burlington, MA 01805-0001 | 2006-09-22 |
| 1326147976 | Carl A. Geyer | Radiology | Lahey Clinic, 41 Mall Road, Burlington, MA 01805-0001 | 2006-09-21 |
| 1265549471 | Peter Gerald Hildenbrand | Radiology | Lahey Clinic, 41 Mall Road, Burlington, MA 01805-0001 | 2006-08-24 |
| Find all providers in BURLINGTON | ||||
| City | BURLINGTON |
| Zip Code | 01805 |
Please comment or provide details below to improve the information on MAXIMILIAN JAMES SMITH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.