Jonathan Maynard, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A136798 Issued in CA

Practice address

18102 Culver Dr
Irvine, CA 92612-2730

Phone

(657) 241-8220

NPI assigned

Aug 28, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: jmaynard1821590@oc.providencedirect.org
• Direct secure messaging: jmaynard862058@direct.memorialcare.org

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.

• Memorialcare Medical Foundation

  • Clinic/Center
  • Fountain Valley, CA
  • NPI 1205167350

  Pediatrics

  Medicare reassignment NPD
• Bristol Park Medical Group, Inc

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1043266760

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1255765020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18102 CULVER DR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122730",
            "telephone_number": "657-241-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18102 CULVER DR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122730",
            "telephone_number": "657-241-8220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9400 Rosecrans Ave",
            "address_purpose": "LOCATION",
            "city": "Bellflower",
            "state": "CA",
            "postal_code": "907062246",
            "country_code": "US",
            "telephone_number": "800-823-4040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "26800 Crown Valley Pkwy Ste 540",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926916384",
            "country_code": "US",
            "telephone_number": "949-242-6915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "JONATHAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-28",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A136798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmaynard1821590@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "26800 Crown Valley Pkwy Ste 540",
            "city": "Mission Viejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926916384",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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": "9400 Rosecrans Ave",
            "city": "Bellflower",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907062246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Adriana Maze, RBT
• Mazhar Medical Group Inc

• Pediatrics Physician in Irvine, CA
• Providers in Irvine, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.