MAXIMINA BOUTSELIS (M.D.) – Diagnostic Radiology Physician, NPI 1013946094
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,563 DIAGNOSTIC RADIOLOGY in PA
Provider Addresses for MAXIMINA BOUTSELIS (M.D.)
1800 E Park Ave
State College, PA 168036701
Phone: (814) 231-7000
Fax: (814) 231-7098
Type: Location
1700 Old Gatesburg Rd Ste 100
State College, PA 168032276
Phone: (814) 278-3280
Fax: (814) 231-7098
Type: Location
1014 Oswegatchie Trail Rd
Star Lake, NY 136903143
Phone: (315) 848-3351
Type: Location
1250 S Cedar Crest Blvd
Allentown, PA 181036224
Phone: (610) 402-8900
Type: Location
20, Follinsbee Lane, West Newbury, Essex County, Massachusetts, 01985, United States
WEST NEWBURY, MA 019854201
Phone: (888) 886-5238
Fax: (888) 886-9330
Type: Mailing
216 NORTHERN BLVD
NEWBURYPORT, MA 019504409
Phone: (978) 761-4606
Type: Mailing
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: 2025-03-31
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 12 Medicare enrollment records; no due dates published yet.
Enrollment records
12
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 |
|---|---|---|---|---|
| I20101201000413 | I | Diagnostic Radiology | MA | TBD |
| I20121017000909 | I | Diagnostic Radiology | IN | TBD |
| I20160308000669 | I | Diagnostic Radiology | PA | TBD |
| I20180503002319 | I | Diagnostic Radiology | OH | TBD |
| I20190918001194 | I | Diagnostic Radiology | NJ | TBD |
| I20220912002287 | I | Diagnostic Radiology | TN | TBD |
| I20221129000523 | I | Diagnostic Radiology | NY | TBD |
| I20240209003843 | I | Diagnostic Radiology | FL | TBD |
| I20240318001185 | I | Diagnostic Radiology | AZ | TBD |
| I20240722001215 | I | Diagnostic Radiology | IL | TBD |
| I20250128000373 | I | Diagnostic Radiology | CO | TBD |
| I20250331001913 | I | Diagnostic Radiology | MI | 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 |
|---|---|---|---|---|
| 71045 | X-ray of chest, 1 view | 507 | 476 | $0 |
| 71046 | X-ray of chest, 2 views | 257 | 246 | $0 |
| 74018 | X-ray of abdomen, 1 view | 74 | 72 | $0 |
| 73502 | X-ray of hip, 2-3 views | 52 | 52 | $0 |
| 73562 | X-ray of knee, 3 views | 50 | 39 | $0 |
Insurance plans in this area (ZIP 16803)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | MS | |
| - | AZ | |
| Cardiac Electrophysiology, Cardiovascular Disease (Cardiology), Internal Medicine | AZ | |
| Diagnostic Radiology | NM | |
| Critical Care (Intensivists), Internal Medicine, Internal Medicine, Pulmonary Disease, Critical Care (Intensivists) | FL | |
| G A S T R O E N T E R O L O G Y | AZ | |
| P S Y C H I A T R Y | NM | |
| Nurse Practitioner | OH | |
| Family Practice | NM | |
| Nurse Practitioner | OH |
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