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MAXIM NIKOLAEVSKIY
NPI 1689426181
Student in an Organized Health Care Education/Training Program in Minneapolis, MN

Active since April 05, 2024PECOS Enrolled
701 PARK AVE, MINNEAPOLIS, MN 55415(612) 873-3000 Get Directions Write a Review

NPPES record last updated: July 13, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 13, 2025, Apr 5, 2024 (2 updates tracked since 2024).

About Maxim Nikolaevskiy NPPES

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

MAXIM NIKOLAEVSKIY (NPI 1689426181) is an individual student in an organized health care education/training program in Minneapolis, Minnesota and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689426181
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMAXIM NIKOLAEVSKIY
Location Address701 PARK AVEMinneapolis, MN 55415-1623
Mailing Address701 Park AveMinneapolis, MN 55415-1623
Phone(612) 873-3000
Sole ProprietorYes
Enumeration DateApril 5, 2024
Last NPPES UpdateJuly 13, 20252 updates tracked since enumeration
NPPES CertifiedJuly 13, 2025
✔ NPI 1689426181 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 80436 (MN)
701 PARK AVE, Minneapolis, MN 55415
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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)

Maxim Nikolaevskiy 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.

DR. MICHAEL CHARLES HARLOW MD
Psychiatry & Neurology (Psychiatry)
701 PARK AVE
MINNEAPOLIS, MN 55415
Hennepin County (612) 873-3000
DANIEL HART
Emergency Medicine
701 PARK AVE
MINNEAPOLIS, MN 55415
Hennepin County (612) 873-3000
GEORGE NOESEN
Dentist (Oral and Maxillofacial Surgery)
701 PARK AVE
MINNEAPOLIS, MN 55415
Hennepin County (612) 873-3000
MRS. CARMODY ALICE SIME LPCC, LADC
Counselor (Professional)
701 PARK AVE
MINNEAPOLIS, MN 55415
Hennepin County (612) 432-2008
MR. JUSTIN GREGORY SCHULZ MD
Student in an Organized Health Care Education/Training Program
701 PARK AVE
MINNEAPOLIS, MN 55415
Hennepin County (612) 873-3000
EVAN SMITH
Emergency Medicine
701 PARK AVE
MINNEAPOLIS, MN 55415
Hennepin County (612) 873-3000
ALEXA M LYON MD
Student in an Organized Health Care Education/Training Program
701 PARK AVE
MINNEAPOLIS, MN 55415
Hennepin County (612) 873-3000
SUMEDHA REDDY BANDI DO
Student in an Organized Health Care Education/Training Program
701 PARK AVE
MINNEAPOLIS, MN 55415
Hennepin County (612) 873-3000

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 Maxim Nikolaevskiy's NPI number?

The NPI number for Maxim Nikolaevskiy is 1689426181. It was assigned to this individual provider in the NPPES registry on April 5, 2024.

Where is Maxim Nikolaevskiy located?

Maxim Nikolaevskiy practices at 701 Park Ave, Minneapolis, MN 55415. The listed phone number is (612) 873-3000.

What is Maxim Nikolaevskiy's specialty?

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

Is Maxim Nikolaevskiy enrolled in Medicare?

Yes. Maxim Nikolaevskiy is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Maxim Nikolaevskiy was last updated on July 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.