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DUSTIN ROSS MAYNE D.O.
NPI 1780045427
Pediatrics in Ellsworth Afb, SD

Active since March 08, 2016PECOS Enrolled
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706(937) 641-3000(937) 641-5931 Get Directions Write a Review

NPPES record last updated: August 5, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 5, 2019, Sep 4, 2018 (2 updates tracked since 2018).

About Dustin Ross Mayne D.o. NPPES

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

DUSTIN ROSS MAYNE D.O. (NPI 1780045427) is an individual pediatrics provider in Ellsworth Afb, South Dakota, licensed in Nebraska (1780) and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780045427
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDUSTIN ROSS MAYNECredential: D.O.
Location Address2900 DOOLITTLE DREllsworth Afb, SD 57706
Mailing Address2900 Doolittle DrEllsworth Afb, SD 57706-4821 · (937) 641-3000 · Fax (937) 641-5931
Phone(937) 641-3000
Fax(937) 641-5931
Sole ProprietorNo
Enumeration DateMarch 8, 2016
Last NPPES UpdateAugust 5, 20192 updates tracked since enumeration
✔ NPI 1780045427 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NE · 1780
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
2900 DOOLITTLE DR, Ellsworth Afb, SD 57706
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Wyoming, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dustin Ross Mayne D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Dustin Mayne reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Memorial Hospital Of Converse County
151 mi
General Practice
111 S 5TH ST
Douglas, WY 82633
  • Reassigned Medicare billing, Wyoming enrollment
  • 131 clinicians in this Medicare group
NPI 1356496491 (307) 358-2122
Banner Hospital Based Physicians West LLC
186 mi
Multi-Specialty
1233 E 2ND ST
Casper, WY 82601
  • Reassigned Medicare billing, Wyoming enrollment
  • 54 clinicians in this Medicare group
NPI 1619464120 (307) 577-2171

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57706 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
$85.21 typical visit price
range $55.52 – $167.23
Typical copayment $21.30 (range $13.88 – $41.80)
Most-billed visit code 99203
Established Patient
$97.88 typical visit price
range $18.08 – $137.08
Typical copayment $24.47 (range $4.52 – $34.27)
Most-billed visit code 99214
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 20

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

MS. CHRISTLE CELESTE USERA MSW/CSW-PIP
Social Worker (Clinical)
2900 DOOLITTLE DR
ELLSWORTH AFB, SD 57706
Meade County (605) 385-3656
28TH MEDGRP-ELLSWORTH
Clinic/Center (Military/U.S. Coast Guard Outpatient)
2900 DOOLITTLE DR
ELLSWORTH AFB, SD 57706
Meade County (605) 385-3311
DR. ERIC WALTER JORCZAK PHARM.D.
Pharmacist
2900 DOOLITTLE DR
ELLSWORTH AFB, SD 57706
Meade County (605) 385-3250
ANTHONY ZUNKER
Military Health Care Provider (Independent Duty Medical Technicians)
2900 DOOLITTLE DR
ELLSWORTH AFB, SD 57706
Meade County (605) 385-3002
MAXWELL TUO CHENG D.O.
General Practice
2900 DOOLITTLE DR
ELLSWORTH AFB, SD 57706
Meade County (605) 385-6700
DR. MICHAEL SCOTT BOGAARD O.D.
Optometrist
2900 DOOLITTLE DR
ELLSWORTH AFB, SD 57706
Meade County (605) 385-3281
DIANE RAMIREZ IDMT
Military Health Care Provider (Independent Duty Medical Technicians)
2900 DOOLITTLE DR
ELLSWORTH AFB, SD 57706
Meade County (605) 835-3332
DR. LAUREN KAY MATTHEWS OD
Optometrist
2900 DOOLITTLE DR
ELLSWORTH AFB, SD 57706
Meade County (605) 385-3283

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 Dustin Mayne's NPI number?

The NPI number for Dustin Mayne is 1780045427. It was assigned to this individual provider in the NPPES registry on March 8, 2016.

Where is Dustin Mayne located?

Dustin Mayne practices at 2900 Doolittle Dr, Ellsworth Afb, SD 57706. The listed phone number is (937) 641-3000.

What is Dustin Mayne's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Dustin Mayne enrolled in Medicare?

Yes. Dustin Mayne is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Dustin Mayne's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dustin Mayne reassigns Medicare benefits to 2 organizations: Memorial Hospital Of Converse County (Douglas, WY) and Banner Hospital Based Physicians West LLC (Casper, WY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dustin Mayne's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dustin Mayne accept?

Health plans from Blue Cross Blue Shield of Wyoming and UnitedHealthcare list Dustin Mayne as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dustin Mayne was last updated on August 5, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.