NPIMap

Individual provider Active NPI

Matthew Scott Payne, D.O

  • Family Medicine Physician
  • Idaho Falls, ID
National Provider Identifier
1023246550
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MR-1068 Issued in ID
Practice address
3200 Channing Way Ste 304
Idaho Falls, ID 83404-7546
Phone
(208) 535-4580
Fax
(208) 535-4520
NPI assigned
Jun 23, 2009
Last updated
Jan 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 000597 AZ
Family Medicine Physician 207Q00000X MR-1068 ID Primary

Addresses

Primary practice location

3200 Channing Way Ste 304
Idaho Falls, ID 83404-7546

Mailing address

PO Box 742337
Atlanta, GA 30374-2337

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MATTHEW.PAYNE@hca3.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141211000723 ID Practitioner - Family Practice 5698926640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Falls Family Medicine LLCGroup PAC ID 9830334200, 5 clinicians

Practice addresses (Care Compare)

3100 Channing Way
Idaho Falls, ID 83404-7533
Phone (208) 529-6111

3200 Channing Way
Suite 304
Idaho Falls, ID 83404-7546
Phone (208) 535-4567

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
000597AZMDFamily Medicine Physician
MR-1068IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Falls Family Medicine, LLC Family Medicine CurrentSince Sep 13, 2014 Accepting new patients

Locations

3100 Channing Way
Idaho Falls, ID 83404
Phone (208) 227-2100

3200 Channing Way
Ste 304
Idaho Falls, ID 83404
Phone (208) 535-4567

3242 S Woodruff Ave
Idaho Falls, ID 83404
Phone (208) 535-4567

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1023246550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742337",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 CHANNING WAY STE 304",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047546",
            "telephone_number": "208-535-4580",
            "fax_number": "208-535-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "MATTHEW",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-23",
        "last_updated": "2022-01-27",
        "certification_date": "2020-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "000597",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "MR-1068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MATTHEW.PAYNE@hca3.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "3200 Channing Way Ste 304",
            "city": "Idaho Falls",
            "state": "ID",
            "country_code": "US",
            "postal_code": "834047546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.