NPIMap

Individual provider Active NPI

Kenneth Bruere Maybury, M.D.

  • Internal Medicine Physician
  • San Francisco, CA
National Provider Identifier
1295733459
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G77043 Issued in CA
Practice address
2250 Hayes St Ste 504
San Francisco, CA 94117-1078
Phone
(415) 422-0998
Fax
(415) 422-0903
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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 G77043 CA Primary

Addresses

Primary practice location

2250 Hayes St Ste 504
San Francisco, CA 94117-1078

Mailing address

2250 Hayes St Ste 504
San Francisco, CA 94117-1078
Phone (415) 422-0998

Other identifiers 1

IdentifierTypeStateIssuer
00G770430MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081201000734 CA Practitioner - Internal Medicine 9638230261 Practice locations: San Francisco, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, San Francisco School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2299 Post St
Suite 303
San Francisco, CA 94115-3474
Phone (415) 422-0998

Hospital & facility affiliations

  • Homeassist Home Health Services Home health agency, Daly City, CA, CCN 559054
  • Healthflex Home Health Services Home health agency, Oakland, CA, CCN 059551
  • Health Link Home Health Agency Home health agency, San Francisco, CA, CCN 059016
  • California Pacific Medical Center- Van Ness Campus Hospital, San Francisco, CA, CCN 050047
  • California Pacific Medical Ctr-Davies Campus Hosp Hospital, San Francisco, CA, CCN 050008
  • UCSF Health St. Mary'S Hospital Hospital, San Francisco, CA, CCN 050457
  • UCSF Medical Center Hospital, San Francisco, CA, CCN 050454

Merit-based Incentive Payment System (MIPS)

Final score
22.37 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
74.57

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Hospitals Past Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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 7

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1295733459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 HAYES ST STE 504",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941171078",
            "telephone_number": "415-422-0998",
            "fax_number": "415-422-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 HAYES ST STE 504",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941171078",
            "telephone_number": "415-422-0998",
            "fax_number": "415-422-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYBURY",
        "first_name": "KENNETH",
        "middle_name": "BRUERE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G77043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G770430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.