DR. NICOLAS KATKHORDEH MAYNARD MD
NPI 1134814726
Student in an Organized Health Care Education/Training Program in Saint Louis, MO

Q: What is Nicolas Maynard's NPI number?

The NPI number for Nicolas Maynard is 1134814726. It was assigned to this individual provider in the NPPES registry on April 10, 2023.

Q: What is Nicolas Maynard's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Nicolas Maynard was last updated on June 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 10, 2023PECOS Enrolled

1402 S GRAND BLVD RM M260, SAINT LOUIS, MO 63104(314) 617-2359 Get Directions Write a Review

NPPES record last updated: June 25, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 25, 2024, Apr 11, 2023 (2 updates tracked since 2023).

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About Dr. Nicolas Katkhordeh Maynard Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NICOLAS KATKHORDEH MAYNARD MD (NPI 1134814726) is an individual student in an organized health care education/training program in Saint Louis, Missouri and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS and maintains a secondary practice location in Sacramento.

NPPES Registry Identity

NPI1134814726

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. NICOLAS KATKHORDEH MAYNARDCredential: MD

Location Address1402 S GRAND BLVD RM M260Saint Louis, MO 63104-1004

Mailing Address1402 S Grand Blvd Rm M260Saint Louis, MO 63104-1004

Phone(314) 617-2359

Sole ProprietorYes

Enumeration DateApril 10, 2023

Last NPPES UpdateJune 25, 20242 updates tracked since enumeration

NPPES CertifiedJune 25, 2024

✔ NPI 1134814726 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1402 S GRAND BLVD RM M260, Saint Louis, MO 63104

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Secondary Practice Location 1

Location 12335 Stockton Blvd, North Addition 5th floorSacramento, CA 95817 · Phone (916) 734-2816

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nicolas Katkhordeh Maynard Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HOURI ESMAEIL KHANIAN MD

Student in an Organized Health Care Education/Training Program