Individual provider Active NPI

Brandon J Payzant, PA-C

  • Psychiatry Physician
  • Las Vegas, NV
National Provider Identifier
1417197971
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
PA1629 Issued in NV
Practice address
1701 W Charleston Blvd Ste 300
Las Vegas, NV 89102-2313
Phone
(702) 251-8000
NPI assigned
Feb 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-794 ID
Psychiatry Physician 2084P0800X PA1629 NV Primary

Addresses

Primary practice location

1701 W Charleston Blvd Ste 300
Las Vegas, NV 89102-2313

Mailing address

1701 W Charleston Blvd Ste 300
Las Vegas, NV 89102-2313
Phone (702) 251-8000

Other identifiers 1

IdentifierTypeStateIssuer
808300800MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20161107000780 NV Practitioner - Physician Assistant 2365599834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PHC of Nevada IncGroup PAC ID 4789766502, 5 clinicians

Practice addresses (Care Compare)

1701 W Charleston Blvd
Suite 300
Las Vegas, NV 89102-2313
Phone (702) 251-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA1629NVMDPsychiatry Physician
PA-794IDMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: brandon.payzant@harmonyhc.directbygreenway.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1417197971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W CHARLESTON BLVD STE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022313",
            "telephone_number": "702-251-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W CHARLESTON BLVD STE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022313",
            "telephone_number": "702-251-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYZANT",
        "first_name": "BRANDON",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-24",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-794",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "PA1629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808300800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.