MEGUMI TAKAYAMA MAYNARD M.D.
NPI 1568860377
Family Medicine in Knoxville, TN

NPI Status: Active since December 10, 2014

Contact Information

900 E. OAK HILL AVENUE
KNOXVILLE, TN
ZIP 37917
Phone: (865) 545-7341

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  • Individual
  • Female
  • Years of Experience 32
  • Family Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MEGUMI MAYNARD

This page provides the complete NPI Profile along with additional information for Megumi Maynard, a primary care provider established in Knoxville, Tennessee with a medical specialization in Family Medicine and more than 32 years of experience. She graduated from University Of Tennessee, Hsc, College Of Medicine in 1995. The healthcare provider is registered in the NPI registry with number 1568860377 assigned on December 2014. The practitioner's primary taxonomy code is 207Q00000X with license number 34368 (TN). The provider is registered as an individual and her NPI record was last updated 12 years ago.

NPI
1568860377
Provider Name
MEGUMI TAKAYAMA MAYNARD M.D.
Gender
Female
Entity Type
Individual
Location Address
900 E. OAK HILL AVENUE KNOXVILLE, TN 37917
Location Phone
(865) 545-7341
Mailing Address
600 SUPERIOR AVENUE, EAST SUITE 2400 CLEVELAND, OH 44114
Mailing Phone
(216) 443-0430
Mailing Fax
Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Graduation Year
1995
Is Sole Proprietor?
No
Enumeration Date
12-10-2014
Last Update Date
12-10-2014
Code Navigator

A primary care provider (PCP) like Megumi Maynard sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
34368
License State
TN
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • Bronze Classic PCP Saver | Cleveland Clinic - HMO
  • Bronze Classic Standard | Cleveland Clinic - HMO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits | Cleveland Clinic - HMO
  • Bronze Simple Chronic Care CKM | Cleveland Clinic - HMO
  • Bronze Simple Diabetes | Cleveland Clinic - HMO
  • Bronze Simple HSA | Cleveland Clinic - HMO
  • Gold Classic Standard | Cleveland Clinic - HMO
  • Gold Elite | Cleveland Clinic - HMO
  • Gold Elite Saver Plus | Cleveland Clinic - HMO
  • Silver Classic Standard | Cleveland Clinic - HMO
  • Silver Elite Saver Plus | Cleveland Clinic - HMO
  • Silver Simple Breathe Easy with Enhanced COPD Benefits | Cleveland Clinic - HMO
  • Silver Simple Chronic Care CKM | Cleveland Clinic - HMO
  • Silver Simple Diabetes | Cleveland Clinic - HMO
  • Silver Simple PCP Saver | Cleveland Clinic - HMO
  • Silver Simple Women's Health with Menopause Benefits | Cleveland Clinic - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Megumi Maynard is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Megumi Maynard is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 2062730898

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20150407002328

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 37 times for 21 patients

Management of oxygen chamber therapy

Oxygen chamber therapy involves breathing pure oxygen in a pressurized room or tube. It's used to treat various conditions like wounds that won't heal due to diabetes or radiation injury. In this therapy, your body's tissues get more oxygen to promote healing and fight infection.

This service was performed 283 times for 41 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $20.38 for a new patient copayment and $23.4 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 37917 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $81.53
  • Minimum New Patient Price $52.64
  • Maximum New Patient Price $160.89
  • Average New Patient Copayment $20.38
  • Minimum New Patient Copayment $13.16
  • Maximum New Patient Copayment $40.22

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $93.6
  • Minimum Established Patient Price $16.72
  • Maximum Established Patient Price $131.41
  • Average Established Patient Copayment $23.4
  • Minimum Established Patient Copayment $4.18
  • Maximum Established Patient Copayment $32.85

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Megumi Maynard is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
PARKWEST MEDICAL CENTER9352 PARK WEST BLVD
KNOXVILLE, TN 37923
(865) 970-9800Acute Care Hospitals

Reviews for MEGUMI TAKAYAMA MAYNARD M.D.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1568860377, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
8
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
6
Unchanged
Pos 7
0
Doubled → 0
Pos 8
3
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 8 → 16 → 7 0 → 0 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 1 + 2 + 8 + 1 + 6 + 6 + 0 + 3 + 1 + 4 + 24 = 63

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 63 is 70. The difference is the calculated check digit.

70 - 63 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1568860377.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1568860377, enumerated as an "individual" on December 10, 2014.

The provider is located at 900 E. OAK HILL AVENUE KNOXVILLE, TN 37917 and the phone number is (865) 545-7341.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: BlueCross BlueShield of Tennessee and Oscar. Please consult your insurance carrier or call the provider to verify.

Megumi Maynard is affiliated with: PARKWEST MEDICAL CENTER.