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JACOB PAUL MAXWELL RN, DNP
NPI 1174157572
Nurse Practitioner - Family in Loma Linda, CA

Active since February 25, 2020PECOS EnrolledAccepts Medicare Assignment
11262 CAMPUS ST, LOMA LINDA, CA 92350(909) 558-1000 Get Directions Write a Review

NPPES record last updated: February 3, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 3, 2021, Feb 25, 2020 (2 updates tracked since 2020).

About Jacob Paul Maxwell Rn, Dnp NPPES

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

JACOB PAUL MAXWELL RN, DNP (NPI 1174157572) is an individual family provider in Loma Linda, California, licensed in California (95015683) and active in the NPI registry since February 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1174157572
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameJACOB PAUL MAXWELLCredential: RN, DNP
Location Address11262 CAMPUS STLoma Linda, CA 92350-1727
Mailing Address1075 W State St Apt A203Redlands, CA 92373-8131 · (661) 858-7555
Phone(909) 558-1000
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateFebruary 25, 2020
Last NPPES UpdateFebruary 3, 20212 updates tracked since enumeration
NPPES CertifiedFebruary 3, 2021
✔ NPI 1174157572 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95015683
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
11262 CAMPUS ST, Loma Linda, CA 92350
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacob Paul Maxwell Rn, Dnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1456750595
PECOS Enrollment IDI20210524000414
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92350 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

KATHERINE HUAY-HSIEN GOH
Nurse Practitioner
11262 CAMPUS ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-1000
KATELYN HORNE
Pharmacist
11262 CAMPUS ST, SCHOOL OF PHARMACY
LOMA LINDA, CA 92350
San Bernardino County (707) 372-3413
NIKA SPENCER RN, AGNP CANDIDATE
Student in an Organized Health Care Education/Training Program
11262 CAMPUS ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4923
JULIUS ERWIN MACROHON REYES
Student in an Organized Health Care Education/Training Program
11262 CAMPUS ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4923
MS. MEGANN LEIGH SYNNOTT
Student in an Organized Health Care Education/Training Program
11262 CAMPUS ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-1000
JACKIE RAYGOZA
Student in an Organized Health Care Education/Training Program
11262 CAMPUS ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4923
LUCHIA LYNETTE HANSEN BSN, RN, AGNP-S
Student in an Organized Health Care Education/Training Program
11262 CAMPUS ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-1000
HEATHER PAULA RODRIGUEZ
Nurse Anesthetist, Certified Registered
11262 CAMPUS ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4923

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Maxwell's NPI number?

The NPI number for Jacob Maxwell is 1174157572. It was assigned to this individual provider in the NPPES registry on February 25, 2020.

Where is Jacob Maxwell located?

Jacob Maxwell practices at 11262 Campus St, Loma Linda, CA 92350. The listed phone number is (909) 558-1000.

What is Jacob Maxwell's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jacob Maxwell enrolled in Medicare?

Yes. Jacob Maxwell is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jacob Maxwell was last updated on February 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.