Individual provider Active NPI

Nyle Maissen, M.D.

  • Pediatric Infectious Diseases Physician
  • Madera, CA
National Provider Identifier
1124258025
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
A135708 Issued in CA
Practice address
9300 Valley Childrens PL
Madera, CA 93636-8761
Phone
(313) 522-2515
NPI assigned
Jul 26, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 49104 TN
Pediatric Infectious Diseases Physician 2080P0208X A135708 CA Primary

Addresses

Primary practice location

9300 Valley Childrens PL
Madera, CA 93636-8761

Mailing address

9300 Valley Childrens PL
Madera, CA 93636-8761
Phone (313) 522-2515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150923001266 CA Practitioner - Pediatric MedicinePractitioner - Infectious Disease 6901042605 Reassigns benefits to 3 organizations
I20230303002416 TX Practitioner - Pediatric MedicinePractitioner - Infectious Disease 6901042605 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Children'S Medical Group Pediatrics CurrentSince Aug 24, 2015 Accepting new patients
Dell Children'S Medical Group CurrentSince Nov 30, 2022 Accepting new patients
Valley Children'S Specialty Medical Group, Inc. Pediatrics CurrentSince Aug 24, 2015 Accepting new patients
Aristamd CurrentSince Apr 1, 2021 Accepting new patients
Dell Children'S Medical Group Pediatrics CurrentSince Nov 30, 2022 Accepting new patients

Locations

9300 Valley Childrens Pl
Madera, CA 93636
Phone (559) 353-5700

1524 McHenry Ave
Ste 550570
Modesto, CA 95350
Phone (209) 572-3880

4755 Nexus Center Dr
San Diego, CA 92121
Phone (858) 750-4777

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

1000 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 628-1800

Interoperability endpoints

  • Direct secure messaging: mohammad.mhaissen.1@8363.direct.athenahealth.com
  • Direct secure messaging: mmhaissen68116@valleychildrens-prd.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1124258025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761",
            "telephone_number": "313-522-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761",
            "telephone_number": "313-522-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAISSEN",
        "first_name": "NYLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-26",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "49104",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "CA",
            "license": "A135708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.