JOHN CLARK MAYBERRY (MD) – Surgery Physician, NPI 1528074077
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,317 GENERAL SURGERY in CA
Provider Addresses for JOHN CLARK MAYBERRY (MD)
5565 GROSSMONT CENTER DR STE 221
LA MESA, CA 919423022
Phone: (619) 462-8100
Fax: (844) 213-3678
Type: Location
7910 FROST ST STE 250
SAN DIEGO, CA 921232752
Phone: (503) 330-7728
Fax: (844) 213-3678
Type: Location
315 S COAST HIGHWAY 101 STE U-535
ENCINITAS, CA 920243543
Phone: (208) 996-5770
Fax: (844) 213-3678
Type: Mailing
PO BOX 1074
CALDWELL, ID 836061074
Phone: (208) 453-4260
Fax: (844) 213-3678
Type: Mailing
1906 FAIRVIEW AVE STE 130
CALDWELL, ID 836055433
Phone: (208) 453-4260
Fax: (844) 213-3678
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $72.
Total Amount is formed as General ($72) + Research ($0) + Ownership ($0) = $72.
Last reported payment date: 2024-04-23 • Largest payer in this snapshot: Kerecis Limited ($45).
Total Amount
$72
General + Research + Ownership
Payments
2
Total payment records
General Amount
$72
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Kerecis Limited | $45 |
| Smith+Nephew, Inc. | $26 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-02-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130911000108 | I | General Surgery | ID | TBD |
| I20170921001115 | I | General Surgery | CA | TBD |
| I20250203001269 | I | General Surgery | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 31 | 20 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 23 | 22 | $0 |
Insurance plans in this area (ZIP 91942)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | ID | |
| Diagnostic Radiology | OK | |
| Emergency Medicine | SC | |
| Nurse Practitioner | OR | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| - | NE | |
| Emergency Medicine | CO | |
| - | MO | |
| Nurse Practitioner | TX | |
| - | SD |
Reviews
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