NPIMap

Individual provider Active NPI

Douglas Kay Mayeda, MD

  • Family Medicine Physician
  • Media, PA
National Provider Identifier
1245867076
Registry record updated Aug 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD480640 Issued in PA
Practice address
605 W State St # 2ND
Media, PA 19063-2620
Phone
(719) 661-9473
NPI assigned
Mar 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD480640 PA Primary

Addresses

Primary practice location

605 W State St # 2ND
Media, PA 19063-2620

Mailing address

605 W State St # 2ND
Media, PA 19063-2620
Phone (719) 661-9473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230629000012 PA Practitioner - Family Practice 8628495959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Drexel University College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

605 W State St
Internal Meds Media
Media, PA 19063-2620
Phone (610) 535-8600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD480640PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health Syst CurrentSince Aug 1, 2023 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Aug 1, 2023 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Family Medicine Current Accepting new patients

Locations

605 W State St
Media, PA 19063
Phone (610) 565-8600

605 W State St
#2
Media, PA 19063
Phone (610) 565-8600

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691884800000",
    "number": "1245867076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 W STATE ST # 2ND",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190632620",
            "telephone_number": "719-661-9473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 W STATE ST # 2ND",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190632620",
            "telephone_number": "719-661-9473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYEDA",
        "first_name": "DOUGLAS",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2023-08-13",
        "certification_date": "2023-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD480640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.