Individual provider Active NPI

Theresa Marie Payne, NP

  • Nurse Practitioner
  • Rancho Mirage, CA
National Provider Identifier
1083705909
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP13322 Issued in CA
Practice address
71511 Highway 111 Ste H
Rancho Mirage, CA 92270-4465
Phone
(760) 773-2200
Fax
(760) 773-2202
NPI assigned
Sep 27, 2006
Last updated
Sep 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP13322 CA Primary

Addresses

Primary practice location

71511 Highway 111 Ste H
Rancho Mirage, CA 92270-4465

Mailing address

71511 Highway 111 Ste H
Rancho Mirage, CA 92270-4465
Phone (760) 773-2200

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140228001259 CA Practitioner - Nurse Practitioner 7911137492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rodolfo R. Batarse, MD, Medical CorporationGroup PAC ID 3173775657, 8 clinicians

Practice addresses (Care Compare)

71511 Hwy 111
Suite H
Rancho Mirage, CA 92270-4465
Phone (760) 773-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP13322CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rodolfo R. Batarse, MD, Medical Corporation CurrentSince Apr 23, 2024 Accepting new patients

Locations

71511 Highway 111
Ste H
Rancho Mirage, CA 92270
Phone (760) 321-8113

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12063/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/EGFJAD/Endpoint/EGFJAD

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1083705909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71511 HIGHWAY 111 STE H",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704465",
            "telephone_number": "760-773-2200",
            "fax_number": "760-773-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71511 HIGHWAY 111 STE H",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704465",
            "telephone_number": "760-773-2200",
            "fax_number": "760-773-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "THERESA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP13322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.