Individual provider Active NPI

Matthew Payne, MD

  • Pediatrics Physician
  • Oklahoma City, OK
National Provider Identifier
1124169008
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
24560 Issued in OK
Practice address
940 NE 13TH St
3N3409
Oklahoma City, OK 73104-5008
Phone
(405) 271-4417
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 24560 OK Primary

Addresses

Primary practice location

940 NE 13TH St
3N3409
Oklahoma City, OK 73104-5008

Mailing address

940 Stanton L Young Blvd
BMSB 357
Oklahoma City, OK 73104-5020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20100611000631 OK Practitioner - Internal Medicine 5092845347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Oklahoma College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stillwater Medical Center AuthorityGroup PAC ID 2365353794, 155 clinicians

Practice addresses (Care Compare)

417 Fairview Ave
Ponca City, OK 74601-1923
Phone (580) 762-3770

Hospital & facility affiliations

  • Stillwater Medical Center Hospital, Stillwater, OK, CCN 370049
  • Stillwater Medical-Blackwell Hospital, Blackwell, OK, CCN 370780
  • Rural Wellness Fairfax Hospital Hospital, Fairfax, OK, CCN 371318
  • Oklahoma Heart Hospital, LLC Hospital, Oklahoma City, OK, CCN 370215
  • Stillwater Medical Center Inpatient rehabilitation facility, Stillwater, OK, CCN 37T049

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24560OKMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stillwater Medical Center Authority CurrentSince Mar 10, 2010 Accepting new patients
Stillwater Medical Center Authority CurrentSince Mar 10, 2010 Accepting new patients
University of Oklahoma College of Medicine Pediatrics Past Accepting new patients
Stillwater Medical Center Authority Past Accepting new patients

Locations

417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124169008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 STANTON L YOUNG BLVD",
            "address_2": "BMSB 357",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 NE 13TH ST",
            "address_2": "3N3409",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045008",
            "telephone_number": "405-271-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "24560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.