JOHN CLARK MAYBERRY MD
NPI 1528074077
Surgery in Caldwell, ID

Q: What is John Mayberry's NPI number?

The NPI number for John Mayberry is 1528074077. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Q: What is John Mayberry's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for John Mayberry was last updated on October 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 01, 2006PECOS EnrolledAccepts Medicare Assignment

1906 FAIRVIEW AVE STE 130, CALDWELL, ID 83605(208) 453-4260(844) 213-3678 Get Directions Write a Review

NPPES record last updated: October 3, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 3, 2023, Nov 25, 2021, Mar 17, 2018 and 4 more (7 updates tracked since 2017).

On this page

About John Clark Mayberry Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHN CLARK MAYBERRY MD (NPI 1528074077) is an individual surgery provider in Caldwell, Idaho, licensed in Idaho (M-12108) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Pine Ridge Ihs Hospital, and is a graduate of Oregon Health Sciences University School Of Medicine (1986).

NPPES Registry Identity

NPI1528074077

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameJOHN CLARK MAYBERRYCredential: MD

Location Address1906 FAIRVIEW AVE STE 130Caldwell, ID 83605-5433

Mailing AddressPo Box 1074Caldwell, ID 83606-1074 · (208) 453-4260 · Fax (844) 213-3678

Phone(208) 453-4260

Fax(844) 213-3678

Sole ProprietorYes

Medical School CMSOregon Health Sciences University School Of MedicineGraduated 1986

Enumeration DateAugust 1, 2006

Last NPPES UpdateOctober 3, 20237 updates tracked since enumeration

NPPES CertifiedOctober 3, 2023

✔ NPI 1528074077 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in ID · M-12108

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Also ListedSurgery · Surgical Critical CareTaxonomy 2086S0102X · License M-12108 (ID)

1906 FAIRVIEW AVE STE 130, Caldwell, ID 83605

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

John Clark Mayberry Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1456247980

PECOS Enrollment IDI20250203001269

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Pine Ridge Ihs Hospital

Acute Care Hospitals · Pine Ridge, SD

OwnershipGovernment - Federal

CMS Certification Number430098

LocationEast Highway 18Pine Ridge, SD 57770 · Oglala Lakota County County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83605 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$65.77 typical visit price

range $16.68 – $130.93

Typical copayment $16.44 (range $4.17 – $32.73)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HIGH DESERT WOUND CARE AND HYPERBARICS PLLC

Emergency Medicine (Undersea and Hyperbaric Medicine)

1906 FAIRVIEW AVE STE 130
CALDWELL, ID 83605

Canyon County (208) 649-8347

ACUTE CARE SOLUTIONS PLLC

Surgery (Trauma Surgery)

1906 FAIRVIEW AVE STE 130
CALDWELL, ID 83605

Canyon County (208) 455-6583

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Mayberry's NPI number?

The NPI number for John Mayberry is 1528074077. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Where is John Mayberry located?

John Mayberry practices at 1906 Fairview Ave Ste 130, Caldwell, ID 83605. The listed phone number is (208) 453-4260.

What is John Mayberry's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is John Mayberry enrolled in Medicare?

Yes. John Mayberry is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is John Mayberry affiliated with any hospitals?

According to CMS data, John Mayberry is affiliated with Pine Ridge Ihs Hospital.

When was this NPI record last updated?

The NPPES record for John Mayberry was last updated on October 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.