Individual provider Active NPI

Carol Ann Payton, PMH-NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Mattituck, NY
National Provider Identifier
1114669447
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F340901-01 Issued in NY
Practice address
11700 Main Rd
Mattituck, NY 11952-1525
Phone
(631) 624-7839
NPI assigned
Apr 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F340901-01 NY Primary

Addresses

Primary practice location

11700 Main Rd
Mattituck, NY 11952-1525

Mailing address

11700 Main Rd
Mattituck, NY 11952-1525
Phone (516) 885-5181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20221026001177 NY Practitioner - Nurse Practitioner 3476929811 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

99 B Main St
Westhampton Beach, NY 11978-2607
Phone (516) 885-5181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F340901-01NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hamptons NP in Psychiatry PLLC Psychiatric/Mental Health CurrentSince May 24, 2023 Accepting new patients
Mary Kathleen Martin Nurse Practitioner in Psychiatry, PLLC CurrentSince Sep 1, 2022 Accepting new patients
Calm Seas Psychotherapy, LCSW,PLLC PastSince Sep 1, 2022 Accepting new patients

Locations

11700 Main Rd
Ste 1
Mattituck, NY 11952
Phone (631) 624-7839

99B Main St
Westhampton Beach, NY 11978
Phone (207) 329-0375

99B Main St
#T
Westhampton Beach, NY 11978

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1114669447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11700 MAIN RD",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "119521525",
            "telephone_number": "516-885-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 MAIN RD",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "119521525",
            "telephone_number": "631-624-7839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYTON",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "credential": "PMH-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F340901-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattituck, NY

Sources for this page

Verify at the official NPI Registry.