Mayo Retina, Inc.

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

License

G83501 Issued in CA

Legal business name

MAYO RETINA, INC.

Practice address

12665 Garden Grove Blvd Ste 300
Garden Grove, CA 92843-1917

Phone

(657) 667-0817

Fax

(657) 667-0819

NPI assigned

Mar 7, 2008

Organization subpart

No

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

Authorized official

Name

George L. MayoNPI 1265591994

Title

MD

Phone

(657) 667-0817

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• George L. Mayo, M.D.

  • Ophthalmology Physician
  • Garden Grove, CA
  • NPI 1265591994
  Medicare reassignment NPD Authorized official
• Katherine A Cosentino, D.O.

  • Obstetrics & Gynecology Physician
  • Orange, CA
  • NPI 1316014152
  NPD (past)

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768003200000",
    "number": "1851561716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 300",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431917",
            "telephone_number": "657-667-0817",
            "fax_number": "657-667-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 300",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431917",
            "telephone_number": "657-667-0817",
            "fax_number": "657-667-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO RETINA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2026-01-10",
        "certification_date": "2026-01-10",
        "status": "A",
        "authorized_official_last_name": "MAYO",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "657-667-0817"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "20A9551",
            "primary": false
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "CA",
            "license": "G83501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Siri Maxwell Sommer
• Alexus Marie Mayares
• Benjamin Mayer
• Daniel Mayer
• Maylei Care LLC
• George L. Mayo, M.D.
• Andres De Jesus Mayorga, RADT
• Pouza Mbah Albright
• MBS Hospice Care Inc
• MC Rehab Corp.

• Ophthalmologic Surgery Clinic/Center in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Ophthalmologic Surgery Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.