Active NPI
Nathan Bradley Payne, PA-C
- Medical Physician Assistant
- Phoenix, AZ
National Provider Identifier
1073948550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 5510
- Practice address
- 1108 W Indian School Rd
Ste B
Phoenix, AZ 85013-3107 - Phone
- (602) 773-5600
- NPI assigned
- Sep 4, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 5510 | AZ | Primary |
Addresses
Primary practice location
1108 W Indian School Rd
Ste B
Phoenix, AZ 85013-3107
Mailing address
1108 W Indian School Rd
Ste B
Phoenix, AZ 85013-3107
Phone (602) 773-5600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 847251 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
8675 S Priest Dr
Suite 102
Tempe, AZ 85284-1914
Phone (480) 739-0007
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- azadhdcenter.nathan.payne@160530.advancedmd-direct.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba ADD Clinic of Arizona
- Family Medicine Physician
- Tempe, AZ
- NPI 1275034183
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392422400000",
"number": "1073948550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1108 W INDIAN SCHOOL RD",
"address_2": "STE B",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850133107",
"telephone_number": "602-773-5600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1108 W INDIAN SCHOOL RD",
"address_2": "STE B",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850133107",
"telephone_number": "602-773-5600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAYNE",
"first_name": "NATHAN",
"middle_name": "BRADLEY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-04",
"last_updated": "2014-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "AZ",
"license": "5510",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "847251",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.