DR. MAXWELL RUSKIN PETTIJOHN O.D.
NPI 1356639322
Optometrist in Denver, CO
About Dr. Maxwell Ruskin Pettijohn O.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MAXWELL RUSKIN PETTIJOHN O.D. (NPI 1356639322) is an individual optometrist in Denver, Colorado, licensed in Colorado (OPT-2856) and active in the NPI registry since July 2011. He is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (2011).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Maxwell Ruskin Pettijohn O.d. 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.
Medicare Billing Reassignment
Medicare enrollment records show Maxwell Pettijohn reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Denver, CO 80247
- Reassigned Medicare billing, Colorado enrollment
- Medicare enrollment name: Colorado Permanente Medical Group PC
- 1,715 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 80247 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Maxwell Pettijohn's NPI number?
The NPI number for Maxwell Pettijohn is 1356639322. It was assigned to this individual provider in the NPPES registry on July 12, 2011.
Where is Maxwell Pettijohn located?
Maxwell Pettijohn practices at 10400 E Alameda Ave, Denver, CO 80247. The listed phone number is (303) 338-4545.
What is Maxwell Pettijohn's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Maxwell Pettijohn enrolled in Medicare?
Yes. Maxwell Pettijohn 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.
Which organization bills Medicare for Maxwell Pettijohn's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Maxwell Pettijohn reassigns Medicare benefits to Colorado Permanente Medical Group, P.C. (Denver, CO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Maxwell Pettijohn's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Maxwell Pettijohn was last updated on May 20, 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.
# Dr. Maxwell Ruskin Pettijohn, O.D. · NPI 1356639322
Optometrist provider in Denver, Colorado. Individual provider, active in the CMS NPPES registry since July 12, 2011.
## Identity
- **NPI:** 1356639322 (Entity type: Individual)
- **Enumerated:** July 12, 2011
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** OPT-2856 (Colorado)
- **Sole proprietor:** No
## Practice location
- **Address:** 10400 E ALAMEDA AVE, Denver, CO 80247-5104
- **Phone:** (303) 338-4545
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Colorado Permanente Medical Group, P.C. (NPI 1760599724, Denver, CO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Illinois College Of Optometry At Chicago, class of 2011
## Record status
- **NPPES last updated:** May 20, 2021
- **Other identifiers:** Other 026644 (CO); Medicaid 07483015 (CO)
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Source: [NPI Profile](https://npiprofile.com/npi/1356639322) · Data from the CMS NPPES public registry.