MAX PIANKA (APRN) – Family Nurse Practitioner, NPI 1417414038

MAX PIANKA (APRN) is a healthcare provider. based in Preston, Connecticut. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 12.008116 (CT). The NPI Number for MAX PIANKA (APRN) is 1417414038

Main info

Male
8 Years Of Experience
Name
MAX PIANKA (APRN)
NPI
1417414038
Phone
Not provided
Address
59 BUNNY RD
Enumeration Date
1 March 2019
Last Update Date
16 September 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2039492700
Graduation Year
2018 (8 years ago)
PAC ID
6608117338
Group Practice PAC ID
4880593565
Professional Enrollment ID
I20190408000973
Address ID
CT064512101ME435XXAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

4,196 NURSE PRACTITIONER in CT

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Provider Addresses for MAX PIANKA (APRN)

  • 59, Bunny Road, Preston City, Preston, New London County, Connecticut, 06365, United States

    PRESTON, CT 063658705

    Phone:

    Type: Mailing

  • Mid State Medical Center, 435, Lewis Avenue, Meriden, New Haven County, Connecticut, 06451, United States

    MERIDEN, CT 064512101

    Phone: (203) 694-5701

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $64.

Total Amount is formed as General ($64) + Research ($0) + Ownership ($0) = $64.

Last reported payment date: 2024-02-08 • Largest payer in this snapshot: AngioDynamics, Inc. ($35).

Total Amount

$64

General + Research + Ownership

Payments

3

Total payment records

General Amount

$64

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-08

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-04-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190408000973INurse PractitionerCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06365)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4880593565View full group profile
NameSpecialtyState
Diagnostic RadiologyRI
Diagnostic RadiologyCT
-IL
Interventional Radiology, Diagnostic RadiologyCT
Diagnostic RadiologyMN
Diagnostic RadiologyMA
Physician AssistantCT
Diagnostic RadiologyCT
Diagnostic RadiologyMA
Diagnostic RadiologyCT

Reviews

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Frequently asked questions

What unique ID ties claims to MAX PIANKA (APRN)?
NPI 1417414038 is assigned to MAX PIANKA (APRN) under the national enumeration system.
Is MAX PIANKA (APRN) active in the national directory?
MAX PIANKA (APRN)'s public NPI profile is in an active state.
What does MAX PIANKA (APRN) treat or focus on?
Patients typically see MAX PIANKA (APRN) under the specialty Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does MAX PIANKA (APRN) practice in Connecticut?
You will see Preston, Connecticut on file for MAX PIANKA (APRN) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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