Active NPI
Cory Kishi Hiro Mayfield, MD
- Orthopaedic Surgery Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 036.178366
- Practice address
- 1611 W Harrison St Ste 400
Chicago, IL 60612-4861 - Phone
- (877) 632-6637
- Fax
- (708) 409-5179
- NPI assigned
- Mar 20, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 036.178366 | IL | Primary |
| Orthopaedic Surgery Physician | 207X00000X | 01099134A | IN | |
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 036.178366 | IL | |
| Orthopaedic Surgery Physician | 207X00000X | A179921 | CA | |
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 01099134A | IN |
Addresses
Primary practice location
1611 W Harrison St Ste 400
Chicago, IL 60612-4861
Mailing address
PO Box 735263
Chicago, IL 60673-5263
Other practice location 1
2051 Marengo St Ste A7D
Los Angeles, CA 90033-1352
Phone (310) 591-6735
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
11440 Arroyo View Dr
Pasadena, CA 91103-1901
PO Box
Suite 393
Seekonk, MA 02771
PO Box
Suite 393
Seekonk, MA 02771-0393
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A179921 | CA | MD | Orthopaedic Surgery Physician |
| 036.178366 | IL | MD | Sports Medicine (Orthopaedic Surgery) Physician |
| 01099134A | IN | MD | Sports Medicine (Orthopaedic Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthomidwest, PLLC | Orthopaedic Surgery | Current | Accepting new patients |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Orthomidwest, PLLC | Current | Accepting new patients |
Locations
1011 Baldwin Park Blvd
Baldwin Park, CA 91706
Phone (626) 851-1011
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526
770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060
1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244
9601 Calumet Ave
Munster, IN 46321
Phone (312) 432-2591
9200 Calumet Ave
Ste 300
Munster, IN 46321
Phone (708) 236-2737
Organizations & group practices 5
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.
-
- Orthopaedic Surgery Physician
- Rockford, IL
- NPI 1730136474
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Durable Medical Equipment & Medical Supplies
- Buffalo Grove, IL
- NPI 1043180839
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Rosemead, CA
- NPI 1942787114
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778198400000",
"number": "1215563283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735263",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 W HARRISON ST STE 400",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124861",
"telephone_number": "877-632-6637",
"fax_number": "708-409-5179"
}
],
"practiceLocations": [
{
"address_1": "2051 Marengo St Ste A7D",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900331352",
"country_code": "US",
"telephone_number": "310-591-6735",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAYFIELD",
"first_name": "CORY",
"middle_name": "KISHI HIRO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-20",
"last_updated": "2026-05-08",
"certification_date": "2026-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "IL",
"license": "036.178366",
"primary": true
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "IN",
"license": "01099134A",
"primary": false
},
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "IL",
"license": "036.178366",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "CA",
"license": "A179921",
"primary": false
},
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "IN",
"license": "01099134A",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1011 Baldwin Park Blvd",
"city": "Baldwin Park",
"state": "CA",
"country_code": "US",
"postal_code": "917065806",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.