Jennifer Purdy Mayberry, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD24376 Issued in OR

Practice address

233 NE 102ND Ave
Portland, OR 97220

Phone

(503) 253-1105

Fax

(503) 535-8398

NPI assigned

Aug 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Mary Jennifer Purdy Former name

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

Specialty

Diagnostic Radiology

Education

University of Arkansas College of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

IHS Radiology Medical Group IncGroup PAC ID 1052622024, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tri-City Medical Center Hospital, Oceanside, CA, CCN 050128
• UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025

Merit-based Incentive Payment System (MIPS)

Final score

35.17 of 100Reported as group

Quality

0

Improvement activities

20

Cost

77.33

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• IHS Radiology Medical Group, Inc.

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1497148456
  Medicare reassignment Care Compare group NPD
• Anesthesia Associates Northwest LLC

  • Anesthesiology Physician
  • Milwaukie, OR
  • NPI 1548281751
  NPD (past)
• Epic Imaging-West, Inc.

  • Diagnostic Radiology Physician
  • Beaverton, OR
  • NPI 1407921208
  NPD (past)
• Physicians Radiology Medical Group, Inc.

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1891741831
  NPD (past)
• San Diego Diagnostic Radiology Medical Group Inc

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1326075375
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Regents of the University of California

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1184722779
  Care Compare affiliation
• Tri-City Hospital

  • General Acute Care Hospital
  • Oceanside, CA
  • NPI 1801861190
  Care Compare affiliation

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467565671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21874 NE PARK LANE",
            "city": "FAIRVIEW",
            "state": "OR",
            "postal_code": "97204",
            "telephone_number": "503-253-1105",
            "fax_number": "503-535-8398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 NE 102ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97220",
            "telephone_number": "503-253-1105",
            "fax_number": "503-535-8398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYBERRY",
        "first_name": "JENNIFER",
        "middle_name": "PURDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD24376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "PURDY",
            "middle_name": "JENNIFER",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alma Erendira Maya Perez
• Brenda Maya-Mota, REGISTERED NURSE
• D'Vorah Brockman Maya, QMHP, LPC, NCC
• Michelle Maya, MSW
• Jason Mayberry, LMT
• Tyler Maybury, RN
• Meaghan M Mayeda Adkins, LCSW, MSW
• Marissa Mayeda
• Nicole Mayeda, PSY.D.
• Chelesa Albrecht Mayer, DPT

• Diagnostic Radiology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Diagnostic Radiology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.