Maxim Nikolaevskiy, is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Minneapolis, Minnesota. His current practice location is
701 Park Ave, Minneapolis, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(612) 873-3000.
Maxim Nikolaevskiy is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1689426181.
Physician's Profile
Full Name | Maxim Nikolaevskiy |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 701 Park Ave, Minneapolis, Minnesota |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1689426181
- Provider Enumeration Date: 04/05/2024
- Last Update Date: 07/13/2025
Medicare PECOS Information:
- PECOS PAC ID: 3375086051
- Enrollment ID: I20240622000191
Medical Identifiers
Medical identifiers for Maxim Nikolaevskiy such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1689426181 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 80436 (Minnesota) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Maxim Nikolaevskiy is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Maxim Nikolaevskiy, 701 Park Ave, Minneapolis, MN 55415-1623 Ph: () - | Maxim Nikolaevskiy, 701 Park Ave, Minneapolis, MN 55415-1623 Ph: (612) 873-3000 |
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