Individual provider Active NPI

Matthew James Maynard, DO

  • Emergency Medicine Physician
  • Sacramento, CA
National Provider Identifier
1366978199
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A16966 Issued in CA
Practice address
2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone
(916) 734-8570
Fax
(916) 734-7950
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X OS18285 FL
Emergency Medicine Physician 207P00000X 20A16966 CA Primary

Addresses

Primary practice location

2315 Stockton Blvd
Sacramento, CA 95817-2201

Mailing address

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-8570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 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
I20200617000656 CA Practitioner - Emergency Medicine 6608297080 Reassigns benefits to 2 organizations
I20230831004691 FL Practitioner - Emergency Medicine 6608297080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

7800 US Hwy 98 W
Miramar Beach, FL 32550-7228
Phone (850) 278-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A16966CAMDEmergency Medicine Physician
16966CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince Jul 1, 2020 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Cep America, LLC Emergency Medicine CurrentSince Aug 15, 2023 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Aug 15, 2023 Accepting new patients
Regents of the University of Ca Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Regents of the University of California CurrentSince Dec 1, 2020 Accepting new patients
Regents of the University of California CurrentSince Dec 1, 2020 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

3160 Folsom Blvd
Ste 2500
Sacramento, CA 95816
Phone (916) 734-5846

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1366978199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "916-734-8570",
            "fax_number": "916-734-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "916-734-8570",
            "fax_number": "916-734-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS18285",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A16966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.