NPIMap

Individual provider Active NPI

Matthew Tam Maynard, D.O.

  • Obstetrics & Gynecology Physician
  • Sonora, CA
National Provider Identifier
1861617417
Registry record updated Oct 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
20A10864 Issued in CA
Practice address
20044 Cedar Rd N Ste a
Sonora, CA 95370-5900
Phone
(209) 536-3750
Fax
(209) 532-9811
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5101015815 MI
Obstetrics & Gynecology Physician 207V00000X T-521 NM
Obstetrics & Gynecology Physician 207V00000X 20A10864 CA Primary

Addresses

Primary practice location

20044 Cedar Rd N Ste a
Sonora, CA 95370-5900

Mailing address

20044 Cedar Rd N Ste a
Sonora, CA 95370-5900
Phone (209) 536-3750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091211000329 CA Practitioner - Obstetrics/Gynecology 0941391056 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Arizona College of Osteopathic Medicine Mid Western University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sonora Community HospitalGroup PAC ID 4284538505, shared by 10 NPIs, 134 clinicians

Practice addresses (Care Compare)

1000 Greenley Rd
Sonora, CA 95370-5200
Phone (209) 536-5000

12811 Covey Cir
Sonora, CA 95370-5935
Phone (209) 536-5196

193 Fairview LN
Sonora, CA 95370-4828
Phone (209) 536-5100

680 Guzzi LN
Sonora, CA 95370-5288

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.78 of 100Reported as group
Quality
81.74
Promoting interoperability
97
Improvement activities
40
Cost
67.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A10864CAMDObstetrics & Gynecology Physician
T-521NMMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sonora Community Hospital Obstetrics & Gynecology CurrentSince Jan 1, 2021 Accepting new patients
Sonora Community Hospital CurrentSince Sep 1, 2009 Accepting new patients
Sonora Community Hospital Current Accepting new patients
Sonora Community Hospital Current Accepting new patients
Sonora Community Hospital CurrentSince Sep 1, 2009 Accepting new patients
Sonora Community Hospital Past Accepting new patients
Ella E. M. Brown Charitable Circle Past Accepting new patients

Locations

1000 Greenley Rd
Sonora, CA 95370
Phone (209) 263-0803

900 Greenley Rd
Ste 922
Sonora, CA 95370
Phone (209) 536-3738

20044 Cedar Rd N
Ste A
Sonora, CA 95370
Phone (209) 536-3750

193 Fairview Ln
Sonora, CA 95370
Phone (209) 536-5100

12811 Covey Cir
Sonora, CA 95370
Phone (209) 536-1785

680 Guzzi Ln
Ste 201
Sonora, CA 95370
Phone (209) 536-1785

193 Fairview Ln
Ste F
Sonora, CA 95370
Phone (209) 536-3277

Organizations & group practices 7

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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255132800000",
    "number": "1861617417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20044 CEDAR RD N STE A",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705900",
            "telephone_number": "209-536-3750",
            "fax_number": "209-532-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20044 CEDAR RD N STE A",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705900",
            "telephone_number": "209-536-3750",
            "fax_number": "209-532-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "MATTHEW",
        "middle_name": "TAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2009-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101015815",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NM",
            "license": "T-521",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A10864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

Verify at the official NPI Registry.