NPIMap

Individual provider Active NPI

Jeffrey M Maire, DO

  • Surgery Physician
  • Audubon, IA
National Provider Identifier
1366557167
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
3603 Issued in IA
Practice address
515 Pacific Ave
Audubon, IA 50025-1056
Phone
(712) 563-5304
Fax
(712) 563-5275
NPI assigned
Aug 20, 2006
Last updated
Sep 25, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 3603 IA Primary

Addresses

Primary practice location

515 Pacific Ave
Audubon, IA 50025-1056

Mailing address

515 Pacific Ave
Audubon, IA 50025-1056
Phone (712) 563-2611

Other identifiers 1

IdentifierTypeStateIssuer
0453886MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20050128000638 IA Practitioner - General Surgery 1759331507 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone County Comprehensive Specialty CareGroup PAC ID 8022012293, 4 clinicians
Audubon County Memorial HospitalGroup PAC ID 7618866096, shared by 5 NPIs, 15 clinicians

Practice addresses (Care Compare)

1015 Union St
Boone, IA 50036-4821
Phone (515) 433-8500

515 Pacific Ave
Audubon, IA 50025-1056
Phone (712) 563-2611

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.09 of 100Reported as group
Quality
92.17
Promoting interoperability
88
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3603IAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boone County Comprehensive Specialty Care Surgery CurrentSince Mar 2, 2015 Accepting new patients
Boone County Hospital Current Accepting new patients
Audubon County Memorial Hospital Current Accepting new patients
Audubon County Memorial Hospital CurrentSince Sep 25, 2017 Accepting new patients
Heartland Regional Medical Center Past Accepting new patients
Heartland Regional Medical Center Past Accepting new patients
Boone County Hospital Past Accepting new patients

Locations

515 Pacific Ave
Audubon, IA 50025
Phone (712) 563-2611

1015 Union St
Boone, IA 50036
Phone (515) 432-3140

1015 Union St
Ste 119
Boone, IA 50036
Phone (515) 433-8500

411 Laurel St
Ste 2100
Des Moines, IA 50314
Phone (515) 418-9960

Interoperability endpoints

  • Direct secure messaging: jmaire228067@uihcdirect.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1366557167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 PACIFIC AVE",
            "city": "AUDUBON",
            "state": "IA",
            "postal_code": "500251056",
            "telephone_number": "712-563-2611",
            "fax_number": "712-563-5298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 PACIFIC AVE",
            "city": "AUDUBON",
            "state": "IA",
            "postal_code": "500251056",
            "telephone_number": "712-563-5304",
            "fax_number": "712-563-5275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIRE",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "3603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0453886",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Audubon, IA

Sources for this page

Verify at the official NPI Registry.