Individual provider Active NPI

Alexis Kaye Maynez, RN, FNP

  • Family Nurse Practitioner
  • El Segundo, CA
National Provider Identifier
1881319168
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95028139 Issued in CA
Practice address
2284 E Maple Ave
El Segundo, CA 90245-6507
Phone
(310) 414-9761
NPI assigned
Oct 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95028139 CA Primary
Registered Nurse 163W00000X 95246151 CA

Addresses

Primary practice location

2284 E Maple Ave
El Segundo, CA 90245-6507

Mailing address

129 Rosecrans Ave Apt B
Manhattan Beach, CA 90266-3498
Phone (575) 430-8253

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240909000794 CA Practitioner - Nurse Practitioner 0648710483 Practice locations: El Segundo, CA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2284 E Maple Ave
El Segundo, CA 90245-6507
Phone (310) 414-9761

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ellyn Levine, MD, Inc. Current Accepting new patients
Walgreen Co PastSince Oct 1, 2022 Accepting new patients
La Skincare Center a Medical Corporation Past Accepting new patients
Walgreen Co PastSince Oct 1, 2022 Accepting new patients

Organizations & group practices 4

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": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1881319168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 ROSECRANS AVE APT B",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902663498",
            "telephone_number": "575-430-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2284 E MAPLE AVE",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902456507",
            "telephone_number": "310-414-9761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNEZ",
        "first_name": "ALEXIS",
        "middle_name": "KAYE",
        "credential": "RN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95028139",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95246151",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

Verify at the official NPI Registry.