Individual provider Active NPI

Jeffrey David Mayne, M.D.

  • Hospitalist Physician
  • Los Angeles, CA
National Provider Identifier
1558597690
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A122017 Issued in CA
Practice address
757 Westwood PLZ Ste 7501
Los Angeles, CA 90095-8358
Phone
(310) 267-9643
Fax
(310) 267-3840
NPI assigned
Jun 3, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X A122017 CA Primary
Internal Medicine Physician 207R00000X A122017 CA

Addresses

Primary practice location

757 Westwood PLZ Ste 7501
Los Angeles, CA 90095-8358

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other identifiers 1

IdentifierTypeStateIssuer
04536710MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY2 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
I20130808000241 CA Practitioner - HospitalistPractitioner - Internal Medicine 7012159775
I20161215000246 NY Practitioner - Internal Medicine 7012159775 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
261136NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice PC Internal Medicine CurrentSince Sep 25, 2016 Accepting new patients

Locations

1351 Route 55
Ste 200
Lagrangeville, NY 12540
Phone (845) 475-9622

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

6511 Spring Brook Ave
Rhinebeck, NY 12572
Phone (845) 871-3368

Organizations & group practices 1

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": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1558597690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ STE 7501",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958358",
            "telephone_number": "310-267-9643",
            "fax_number": "310-267-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNE",
        "first_name": "JEFFREY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-03",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A122017",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A122017",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04536710",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.