Individual provider Active NPI

Robert Mitchell Maywood, M.D.

  • Orthopaedic Surgery Physician
  • San Diego, CA
National Provider Identifier
1487737524
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G80692 Issued in CA
Practice address
3444 Kearny Villa Rd
Suite # 401
San Diego, CA 92123-1959
Phone
(858) 616-6400
Fax
(858) 616-6936
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G80692 CA Primary

Addresses

Primary practice location

3444 Kearny Villa Rd
Suite # 401
San Diego, CA 92123-1959

Mailing address

3444 Kearny Villa Rd
Suite # 401
San Diego, CA 92123-1959
Phone (858) 616-6400

Other identifiers 1

IdentifierTypeStateIssuer
G80692OtherCACA STATE LIC

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040130000399 CA Practitioner - Orthopedic Surgery 8224931811 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Temecula Medical Corporation Orthopaedic Surgery CurrentSince Mar 10, 2017 Accepting new patients
Thomas W. Harris MD Inc Past Accepting new patients
Aventura Orthopedicare Center PA Orthopaedic Surgery PastSince Jun 29, 2011 Accepting new patients
Walter Alain Thomas M D Inc Orthopaedic Surgery Past Accepting new patients
Synergy Orthopedic Specialists, Inc. Orthopaedic Surgery PastSince Nov 1, 2015 Accepting new patients

Locations

41715 Winchester Rd
Ste 101
Temecula, CA 92590
Phone (858) 616-6400

41715 Winchester Rd
Ste 202
Temecula, CA 92590
Phone (951) 296-0788

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1487737524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3444 KEARNY VILLA RD",
            "address_2": "SUITE # 401",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231959",
            "telephone_number": "858-616-6400",
            "fax_number": "858-616-6936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3444 KEARNY VILLA RD",
            "address_2": "SUITE # 401",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231959",
            "telephone_number": "858-616-6400",
            "fax_number": "858-616-6936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYWOOD",
        "first_name": "ROBERT",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G80692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA STATE LIC",
            "identifier": "G80692",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.