John Clark Mayberry, MD
NPI 1528074077ActiveIndividual· Surgery· Caldwell, ID
Surgery (MD) in Caldwell, Idaho, trained at Oregon Health Sciences University School of Medicine (class of 1986). Mostly services rather than prescriptions: Medicare paid $6,442 for 22 patients in 2024, with only 15 Part D claims. Kerecis Limited reported $43.18 in payments in 2025, mostly food and beverage.
Overview
| NPI | 1528074077 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MD |
| Sole proprietor | Yes |
| NPI issued | Aug 1, 2006 |
| Last updated in NPPES | Oct 3, 2023 |
| Certified by provider | Oct 3, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery Primary | 208600000X | M-12108 | ID |
| Surgery, Surgical Critical Care | 2086S0102X | M-12108 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - General Surgery (CA); Practitioner - General Surgery (ID); Practitioner - General Surgery (TX) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 22 |
|---|---|
| Services billed | 48 across 18 procedure codes |
| Paid by Medicare | $6,442 |
Part D prescriptions in 2024
| Prescriptions (claims) | 15 · 15 30-day fills |
|---|---|
| Total drug cost | $1,638 |
| Generic share | 80% of claims |
Education and affiliations
| Medical school | Oregon Health Sciences University School of Medicine |
|---|---|
| Graduation year | 1986 |
| Medicare specialty | General Surgery |
Medical group
- Pine Ridge Indian Health Service HospitalPine Ridge, SD · 108 clinicians
Hospital affiliation
- Pine Ridge Ihs HospitalPine Ridge, SD
Industry payments (Open Payments)
- 2025$43.18 · 2 payments from 1 company
- 2024$45.43 · 1 payment from 1 company
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Kerecis Limited | $43.18 | 2 |
What the 2025 payments were for
- Food and Beverage$43.18 · 2 payments
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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