Individual provider Active NPI

Mayra Robinson Herasme, MD

  • Pediatrics Physician
  • Madera, CA
National Provider Identifier
1851797328
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A169015 Issued in CA
Practice address
124 S a St
Madera, CA 93638-3619
Phone
(559) 664-4042
NPI assigned
Nov 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X A169015 CA Primary

Addresses

Primary practice location

124 S a St
Madera, CA 93638-3619

Mailing address

124 S a St
Madera, CA 93638-3619
Phone (559) 664-4042

Other practice location 1

900 Main St
Brawley, CA 92227-2630
Phone (760) 344-6471

Other practice location 2

760 Broadway
Brooklyn, NY 11206-5317
Phone (718) 963-7956

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
I20220411002396 CA Practitioner - Pediatric Medicine 4385910967 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A169015CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Camarena Health CurrentSince Oct 19, 2022 Accepting new patients
Camarena Health CurrentSince Oct 19, 2022 Accepting new patients
Camarena Health Pediatrics Current Accepting new patients
Clinicas de Salud del Pueblo, Inc. CurrentSince Dec 31, 2021 Accepting new patients
Clinicas de Salud del Pueblo Inc. CurrentSince Dec 31, 2021 Accepting new patients
Clinicas de Salud del Pueblo, Inc Current Accepting new patients

Locations

900 Main St
Brawley, CA 92227
Phone (760) 344-6471

223 W Cole Blvd
Calexico, CA 92231
Phone (760) 357-2020

852 E Danenberg Dr
El Centro, CA 92243
Phone (760) 352-2257

441 E Yosemite Ave
Madera, CA 93638

124 S A St
Madera, CA 93638
Phone (559) 664-4042

49169 Road 426
Oakhurst, CA 93644
Phone (559) 642-6724

Interoperability endpoints

  • Direct secure messaging: mayra.robinson.p1@direct.cdsdp.nextgenshare.com
  • Direct secure messaging: mayra.robinson.herasme.1@25900.direct.athenahealth.com

Organizations & group practices 6

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": "1415664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1851797328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 S A ST",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936383619",
            "telephone_number": "559-664-4042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 S A ST",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936383619",
            "telephone_number": "559-664-4042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Main St",
            "address_purpose": "LOCATION",
            "city": "Brawley",
            "state": "CA",
            "postal_code": "922272630",
            "country_code": "US",
            "telephone_number": "760-344-6471",
            "fax_number": "760-344-8410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "760 Broadway",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112065317",
            "country_code": "US",
            "telephone_number": "718-963-7956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBINSON HERASME",
        "first_name": "MAYRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-11",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A169015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.