Individual provider Active NPI

Dennis Payne, MD

  • Psychiatry Physician
  • San Bernardino, CA
National Provider Identifier
1043242696
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A45903 Issued in CA
Practice address
303 E Vanderbilt Way
San Bernardino, CA 92415-0026
Phone
(909) 388-0810
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A45903 CA Primary

Addresses

Primary practice location

303 E Vanderbilt Way
San Bernardino, CA 92415-0026

Mailing address

PO Box 947
San Marcos, CA 92079-0947

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090630000231 CA Practitioner - PsychiatryPractitioner - NeurologyPractitioner - Addiction Medicine 1557412772 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Indian Health Council IncGroup PAC ID 5294644795, 21 clinicians

Practice addresses (Care Compare)

50100 Golsh Rd
Valley Center, CA 92082-5338
Phone (760) 749-1410

838 Nordahl Rd
Suite 310
San Marcos, CA 92069-3599
Phone (442) 999-5977

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A45903CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis W. B. Payne, MD a Professional Corporation Psychiatry CurrentSince Dec 16, 2020 Accepting new patients
County of San Bernardino CurrentSince Nov 11, 2014 Accepting new patients
County of San Bernardino CurrentSince Nov 11, 2014 Accepting new patients
County of San Bernardino Current Accepting new patients
Indian Health Council, Inc CurrentSince Apr 15, 2016 Accepting new patients

Locations

17053 Foothill Blvd
Bldg B
Fontana, CA 92335
Phone (909) 347-1300

850 E Foothill Blvd
Rialto, CA 92376
Phone (909) 421-9200

838 Nordahl Rd
Ste 310
San Marcos, CA 92069
Phone (442) 999-5977

303 E Vanderbilt Way
Sn Bernrdno, CA 92415
Phone (909) 388-0801

50100 Golsh Rd
Valley Center, CA 92082
Phone (760) 749-1410

12625 Hesperia Rd
Victorville, CA 92395
Phone (760) 955-1777

Interoperability endpoints

  • Direct secure messaging: dpayne713121@direct.ochin.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480982400000",
    "number": "1043242696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920790947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E VANDERBILT WAY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150026",
            "telephone_number": "909-388-0810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2016-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A45903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.