MAXIMILIAN STAEBLER
NPI 1366009649
Student in an Organized Health Care Education/Training Program in Boston, MA

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since May 22, 2019PECOS Enrolled

55 FRUIT ST, BOSTON, MA 02114(617) 726-3030 Get Directions Write a Review

NPPES record last updated: June 27, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 27, 2024, May 22, 2019 (2 updates tracked since 2019).

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About Maximilian Staebler NPPES

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

MAXIMILIAN STAEBLER (NPI 1366009649) is an individual student in an organized health care education/training program in Boston, Massachusetts and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1366009649

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameMAXIMILIAN STAEBLER

Location Address55 FRUIT STBoston, MA 02114-2696

Mailing Address55 Fruit StBoston, MA 02114-2696 · (617) 726-3030

Phone(617) 726-3030

Sole ProprietorYes

Enumeration DateMay 22, 2019

Last NPPES UpdateJune 27, 20242 updates tracked since enumeration

NPPES CertifiedJune 27, 2024

✔ NPI 1366009649 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.

55 FRUIT ST, Boston, MA 02114

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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 (PECOS)

Maximilian Staebler 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.