NPIMap

Individual provider Active NPI

Jennifer Kate Mayben, M.D.

  • Internal Medicine Physician
  • Fredericksburg, TX
National Provider Identifier
1194746685
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L8427 Issued in TX
Practice address
1308 South Highway 16
Fredericksburg, TX 78624-5058
Phone
(830) 997-2181
Fax
(830) 997-9598
NPI assigned
Jul 21, 2006
Last updated
Apr 4, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L8427 TX Primary

Addresses

Primary practice location

1308 South Highway 16
Fredericksburg, TX 78624-5058

Mailing address

1308 South Highway 16
Fredericksburg, TX 78624-5058
Phone (830) 997-2181

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041006001259 TX Practitioner - Internal Medicine 7113986035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical Branch at Galveston, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fredericksburg Clinic PLLCGroup PAC ID 3375515992, 10 clinicians

Practice addresses (Care Compare)

1308 S Hwy 16
Fredericksburg, TX 78624-5058
Phone 8309972181290

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L8427TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fredericksburg Clinic, PLLC Internal Medicine CurrentSince Apr 1, 2009 Accepting new patients

Locations

1308 S State Highway 16
Fredericksburg, TX 78624
Phone (830) 997-2181

Interoperability endpoints

  • Direct secure messaging: jennifer.mayben@854391770316804.direct.elationemr.com

Organizations & group practices 1

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

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1194746685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 SOUTH HIGHWAY 16",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786245058",
            "telephone_number": "830-997-2181",
            "fax_number": "830-997-9598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 SOUTH HIGHWAY 16",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786245058",
            "telephone_number": "830-997-2181",
            "fax_number": "830-997-9598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYBEN",
        "first_name": "JENNIFER",
        "middle_name": "KATE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L8427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, TX

Sources for this page

Verify at the official NPI Registry.