MATTHEW DEAN MAYNARD (NPI# 1790079499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790079499 |
| Entity Type | Individual |
| Full Name | MATTHEW DEAN MAYNARD |
| Credential | DO |
| Practice Address |
830 Washington St Watertown NY 13601-4034 |
| Practice Telephone | 3157864813 |
| Mailing Telephone | 3157795244 |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2018-03-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 269418 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03983768 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861617417 | Matthew Tam Maynard | Obstetrics & Gynecology | 20044 Cedar Rd N Ste A, Sonora, CA 95370-5900 | 2007-04-16 |
| 1497805337 | Matthew James Maynard | Dentist | 3325 Smokey Point Dr Ste 101, Arlington, WA 98223-7803 | 2007-01-11 |
| 1366978199 | Matthew James Maynard | Emergency Medicine | 2315 Stockton Blvd, Sacramento, CA 95817-2201 | 2017-05-11 |
| 1407305659 | Matthew James Maynard | Physician Assistant | 812 Gorman Ave, Elkins, WV 26241-3181 | 2016-09-29 |
| 1235532011 | Matthew Maynard | Marriage & Family Therapist | 3 Sylvan Rd S, Westport, CT 06880-4639 | 2014-10-07 |
| 1972886216 | Matthew Christopher Maynard | Occupational Therapist | 850 E Butler Rd, Greenville, SC 29607-5842 | 2011-09-22 |
| Street Address |
830 WASHINGTON ST |
| City | WATERTOWN |
| State | NY |
| Zip Code | 13601-4034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871597724 | Doris Elaine Grimes | Specialist | 830 Washington St, Watertown, NY 13601-4034 | 2005-06-09 |
| 1386245033 | Sheryl Lynn Abbott | Physician Assistant | 830 Washington St, Watertown, NY 13601-4099 | 2020-11-07 |
| 1730718958 | Shanmukha Swetha Perabattula | Student in an Organized Health Care Education/Training Program | 830 Washington St, Watertown, NY 13601-4099 | 2020-04-08 |
| 1427687771 | Farah Wani | Student in an Organized Health Care Education/Training Program | 830 Washington St, Watertown, NY 13601-4099 | 2020-04-07 |
| 1396383170 | Kaitlin Effie Clark | Physical Therapist | 830 Washington St, Watertown, NY 13601-4034 | 2019-12-12 |
| 1730727546 | Brittany Rose Lothrop | Physical Therapist | 830 Washington St, Watertown, NY 13601-4034 | 2019-12-12 |
| 1598303430 | Jeremy Tarwater | Physical Therapist | 830 Washington St, Watertown, NY 13601-4034 | 2019-12-11 |
| 1609425081 | Heather D Seldat | Nurse Practitioner | 830 Washington St, Watertown, NY 13601-4034 | 2019-09-09 |
| 1649835679 | Timothy Schwarz | Student in an Organized Health Care Education/Training Program | 830 Washington St, Watertown, NY 13601-4099 | 2019-05-06 |
| 1609338201 | Danielle Kealy | Speech-Language Pathologist | 830 Washington St, Watertown, NY 13601-4034 | 2019-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801414156 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 122 Court Street, Empsall Bldg, Room 212, Watertown, NY 13601 | 2020-07-13 |
| 1083231377 | Katherine Anne Cahill | Counselor | 22679 Duffy Road, Watertown, NY 13601 | 2020-07-02 |
| 1851855431 | Hanna Kearney | Physical Therapist | 20053 Summit View Blvd Ste 2, Watertown, NY 13601 | 2019-01-28 |
| 1578039905 | North Country Counseling Services LLC | Counselor | 210 Court St. Suite 4, Watertown, NY 13601 | 2018-10-24 |
| 1073004388 | Megan Anna O'brien | Counselor | 221 S Rutland Street, Watertown, NY 13601 | 2018-05-22 |
| 1558860536 | Kimberly Lynne Amelio | Specialist | 24850 Hinds Rd, Watertown, NY 13601 | 2018-02-06 |
| 1952840050 | Alberto Gonzalez | Social Worker | 211 Jb Wise Plaza, Watertown, NY 13601 | 2017-02-22 |
| 1073967386 | Amanda Pisarski | Licensed Practical Nurse | 26713 Nys Rte 12, Watertown, NY 13601 | 2016-04-22 |
| 1396137709 | Daniel Ernest Morgan | Neuromusculoskeletal Medicine & OMM | 21101 Ny-12f, Building 2, Suite 7, Watertown, NY 13601 | 2015-02-21 |
| 1568868131 | Megan E. Zamora | Dental Hygienist | 14652-b Cedar Way, Watertown, NY 13601 | 2014-11-10 |
| Find all providers in zip 13601 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992750996 | Mt Auburn Professional Services | Emergency Medicine | One Arsenal Marketplace, Watertown, MA 02472-2861 | 2006-05-24 |
| 1396727749 | Christopher Philip Black | Emergency Medicine | 18983 Us Route 11, Watertown, NY 13601-5320 | 2005-11-18 |
| 1629074232 | Jill Christine Peterson | Emergency Medicine | 622 Washington St, Comprehensive Womens Health Services, Watertown, NY 13601-4036 | 2005-06-28 |
| 1972023083 | Katelynn Elizabeth Bailey | Emergency Medicine | 401 9th Ave Nw, Watertown, SD 57201-1548 | 2017-06-21 |
| 1811422272 | David Youngs | Emergency Medicine | 830 Washington St, Watertown, NY 13601-4034 | 2017-04-24 |
| 1558818492 | Wisconsin Physician Services Sc | Emergency Medicine | 125 Hospital Dr, Watertown, WI 53098-3303 | 2016-09-08 |
| 1144462748 | Brian David Roggie | Emergency Medicine | 830 Washington St, Watertown, NY 13601-4034 | 2009-03-27 |
| 1659528180 | Ping Fu | Emergency Medicine | 830 Washington St, Watertown, NY 13601-4034 | 2008-08-27 |
| 1295922334 | Peter S.c. De Jager | Emergency Medicine | 830 Washington St, Watertown, NY 13601-4034 | 2007-10-03 |
| 1164640306 | Mt Auburn Professional Services | Emergency Medicine | One Arsenal Marketplace, Watertown, MA 02472 | 2007-04-23 |
| Find all providers in WATERTOWN | ||||
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| 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.