MAX H HINES (PH.D.) – Psychologist, NPI 1811993983

MAX H HINES (PH.D.) is a healthcare provider. based in Bloomington, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. LP4509 (MN). The NPI Number for MAX H HINES (PH.D.) is 1811993983

Main info

Male
Sole Proprietor
43 Years Of Experience
Accepts Medicare Assignment
Name
MAX H HINES (PH.D.)
NPI
1811993983
Phone
(952) 835-0372
Address
3304 SHEPHERD HILLS DR
Enumeration Date
23 June 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4258065021
Graduation Year
1983 (43 years ago)
PAC ID
3779668751
Group Practice PAC ID
4688766066
Professional Enrollment ID
I20140311000892
Address ID
WA980113758BO10634DRXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,110 CLINICAL PSYCHOLOGIST in MN

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Provider Addresses for MAX H HINES (PH.D.)

  • Shepherd Hills Drive, Bloomington, Hennepin County, Minnesota, 55431, United States

    BLOOMINGTON, MN 554311541

    Phone: (952) 835-0372

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2014-03-11

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
I20140311000892IClinical PsychologistWATBD

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 55431)

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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: 4688766066View full group profile
NameSpecialtyState
Nurse PractitionerWA
P S Y C H I A T R YMN
Psychiatry, Addiction MedicineWA
-WA

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Frequently asked questions

What is the standard ID for MAX H HINES (PH.D.) in the U.S.?
In the U.S., MAX H HINES (PH.D.) is identified by NPI 1811993983.
Is MAX H HINES (PH.D.) currently accepting referrals based on NPI status?
Registry metadata lists MAX H HINES (PH.D.) as active.
Which specialty label fits MAX H HINES (PH.D.)?
NPPES ties MAX H HINES (PH.D.) to Psychologist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to MAX H HINES (PH.D.)?
The directory associates MAX H HINES (PH.D.) with Bloomington, Minnesota. Check all listed addresses for suites or satellite offices.
Can I export MAX H HINES (PH.D.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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