MAXI EDRA DAX (PA) – Medical Physician Assistant, NPI 1538617014

MAXI EDRA DAX (PA) is a healthcare provider. based in Panguitch, Utah. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 10079306-1206 (UT). The NPI Number for MAXI EDRA DAX (PA) is 1538617014

Main info

Female
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
MAXI EDRA DAX (PA)
NPI
1538617014
Phone
(435) 690-1246
Address
95 NORTH 100 EAST
Enumeration Date
14 September 2016
Last Update Date
25 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4356768842
Graduation Year
2016 (10 years ago)
PAC ID
5890075253
Group Practice PAC ID
6305744459
Professional Enrollment ID
I20161201001469
Address ID
UT847590389PA200XX400X301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

1,972 PHYSICIAN ASSISTANT in UT

Provider Addresses for MAXI EDRA DAX (PA)

  • 95 NORTH 100 EAST

    P.O.BOX 738

    PANGUITCH, UT 84759

    Phone: (435) 690-1246

    Type: Mailing

  • 200 NORTH 400 EAST

    PANGUITCH, UT 84759

    Phone: (435) 690-1246

    Type: Location

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: 2016-12-01

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
I20161201001469IPhysician AssistantUTTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes4731$0
99238Hospital discharge day management, 30 minutes or less1919$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes1615$0
View full utilization report →

Insurance plans in this area (ZIP 84759)

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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: 6305744459View full group profile
NameSpecialtyState
Family PracticeUT
Family PracticeUT
Family PracticeUT
Nurse PractitionerUT
Family PracticeOR
Family PracticeUT
Certified Registered Nurse Anesthetist (Crna)UT
Certified Registered Nurse Anesthetist (Crna)UT
Nurse PractitionerUT

Reviews

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Frequently asked questions

How do I look up MAXI EDRA DAX (PA) by NPI?
Use NPI 1538617014 when you need to reference MAXI EDRA DAX (PA) in forms, claims, or directories.
Is MAXI EDRA DAX (PA) active in the national directory?
MAXI EDRA DAX (PA)'s public NPI profile is in an active state.
What field does MAXI EDRA DAX (PA) work in?
You can think of MAXI EDRA DAX (PA) as practicing within Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Does MAXI EDRA DAX (PA) practice in Utah?
You will see Panguitch, Utah on file for MAXI EDRA DAX (PA) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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