Individual provider Active NPI

Margaret Grace Payne, MD

  • Pediatrics Physician
  • Oakland, CA
National Provider Identifier
1346343464
Registry record updated Jul 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G38756 Issued in CA
Practice address
3451 E 12TH St
Oakland, CA 94601
Phone
(510) 535-3600
Fax
(510) 535-4247
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2010

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 G38756 CA Primary

Addresses

Primary practice location

3451 E 12TH St
Oakland, CA 94601

Mailing address

1601 Fruitvale Ave
Oakland, CA 94601-2322
Phone (510) 535-4000

Other identifiers 4

IdentifierTypeStateIssuer
ZZZ29799ZOtherCAFQHC MEDICARE PART B
FHC71021FMedicaidCA
55-1975OtherCAFQHC MEDICARE PART A
HAP71021FOtherCAFPACT

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
I20040804001586 CA Practitioner - Pediatric Medicine 8123099843 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G38756CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de la Raza Inc CurrentSince Jul 11, 2010 Accepting new patients
La Clinica de la Raza Inc CurrentSince Jul 11, 2010 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Locations

3451 E 12th St
Fl 2
Oakland, CA 94601
Phone (510) 535-3319

3451 E 12th St
Oakland, CA 94601
Phone (510) 535-3319

Interoperability endpoints

  • Direct secure messaging: ppayne306685@direct.ochin.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278720000000",
    "number": "1346343464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 FRUITVALE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012322",
            "telephone_number": "510-535-4000",
            "fax_number": "510-535-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 E 12TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94601",
            "telephone_number": "510-535-3600",
            "fax_number": "510-535-4247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "MARGARET",
        "middle_name": "GRACE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2010-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G38756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FQHC MEDICARE PART B",
            "identifier": "ZZZ29799Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC71021F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FQHC MEDICARE PART A",
            "identifier": "55-1975",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FPACT",
            "identifier": "HAP71021F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.