Individual provider Active NPI

Cory Kishi Hiro Mayfield, MD

  • Orthopaedic Surgery Physician
  • Chicago, IL
National Provider Identifier
1215563283
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036.178366 Issued in IL
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

Updated by the provider on May 8, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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, IL2 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
I20221108003269 CA Practitioner - Orthopedic Surgery 7719383793 Reassigns benefits to 1 organization
I20260210001340 IL Practitioner - Orthopedic Surgery 7719383793 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
A179921CAMDOrthopaedic Surgery Physician
036.178366ILMDSports Medicine (Orthopaedic Surgery) Physician
01099134AINMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC Orthopaedic Surgery CurrentSince Feb 13, 2026 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 2, 2022 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 2, 2022 Accepting new patients
Orthomidwest, PLLC CurrentSince Feb 13, 2026 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.

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

Verify at the official NPI Registry.