DR. MAXWELL DAVID JOLLY (M.D.) – Anesthesiology Physician, NPI 1184158438
Anesthesiology Physician
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Profile Insights
NPPES metrics only — not quality of care.
580 ANESTHESIOLOGY in OK
Provider Addresses for DR. MAXWELL DAVID JOLLY (M.D.)
4409 NW 54th St
Oklahoma City, OK 731122150
Phone: (316) 390-8655
Type: Location
2339, North Rutland Court, Sycamore Village, Minneha, Wichita, Sedgwick County, Kansas, 67226, United States
WICHITA, KS 672261116
Phone:
Type: Mailing
4409 NW 54TH ST
OKLAHOMA CITY, OK 731122150
Phone: (319) 390-8655
Type: Mailing
101 MANNING DR
CHAPEL HILL, NC 275144220
Phone: (984) 974-1000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $320.
Total Amount is formed as General ($320) + Research ($0) + Ownership ($0) = $320.
Last reported payment date: 2023-02-12 • Largest payer in this snapshot: Edwards Lifesciences Corporation ($162).
Total Amount
$320
General + Research + Ownership
Payments
5
Total payment records
General Amount
$320
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-02-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Edwards Lifesciences Corporation | $162 |
| SPR Therapeutics, Inc | $136 |
| Avanos Medical | $22 |
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: 2022-05-13
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220513002357 | I | Anesthesiology | KS | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 76942 | Ultrasonic guidance for needle placement | 25 | 25 | $0 |
| 64415 | Injection of anesthetic agent and/or steroid into arm nerve bundle (brachial plexus) | 20 | 20 | $0 |
| 64450 | Injection of anesthetic agent and/or steroid into other nerve or branch | 18 | 18 | $0 |
Insurance plans in this area (ZIP 73112)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | KS | |
| Certified Registered Nurse Anesthetist (Crna) | KS | |
| Certified Registered Nurse Anesthetist (Crna) | KS | |
| Certified Registered Nurse Anesthetist (Crna) | KS | |
| A N E S T H E S I O L O G Y | MO | |
| Certified Registered Nurse Anesthetist (Crna) | KS | |
| A N E S T H E S I O L O G Y | CO | |
| Certified Registered Nurse Anesthetist (Crna) | KS | |
| Certified Registered Nurse Anesthetist (Crna) | KS | |
| Certified Registered Nurse Anesthetist (Crna) | KS |
Reviews
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