Adam James Mayberry, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085007405 Issued in IL

Practice address

1500 S Fairfield Ave
Chicago, IL 60608-1782

Phone

(312) 498-6037

NPI assigned

Jan 27, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mount Sinai Community FoundationGroup PAC ID 5991600405, 247 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mt Sinai Hospital Medical Center Hospital, Chicago, IL, CCN 140018

Merit-based Incentive Payment System (MIPS)

Final score

94.03 of 100Reported as group

Quality

71.53

Promoting interoperability

100

Improvement activities

40

Cost

76.89

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Mount Sinai Community Foundation

  • Rehabilitation Hospital
  • Chicago, IL
  • NPI 1376715896
  Medicare reassignment Care Compare group
• Mount Sinai Community Foundation

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1982657854

  Multi-Specialty

  NPD
• SMG South State Health Center

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1366787012

  Multi-Specialty

  NPD

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

• Mount Sinai Hospital Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1871581314
  Care Compare affiliation

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1902437296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 W LYNDALE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472811",
            "telephone_number": "312-498-6037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S FAIRFIELD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081782",
            "telephone_number": "312-498-6037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYBERRY",
        "first_name": "ADAM",
        "middle_name": "JAMES",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085007405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maya Jimenez LCSW PLLC
• Maya Sedation LLC
• Guadalupe Maya-Veskovic, LCSW
• Orli Maya
• Jessica Mayans
• Johnel Mayberry, M.D.
• Lisa L Mayberry, SLP
• Elizabeth Yumi Maybin, PA-C
• Jay Hirsh Mayefsky, M.D., M.P.H.
• Lorel Mayer Neal, MSN,CNM

• Medical Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.