Individual provider Active NPI

Adam John Payne, PA-C

  • Physician Assistant
  • Fishkill, NY
National Provider Identifier
1417279035
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
028346 Issued in NY
Practice address
969 Main St Ste D
Fishkill, NY 12524-1791
Phone
(845) 896-7730
Fax
(845) 896-7758
NPI assigned
Feb 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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 028346 NY Primary
Dermatology Physician 207N00000X 028346 NY

Addresses

Primary practice location

969 Main St Ste D
Fishkill, NY 12524-1791

Mailing address

969 Main St Ste D
Fishkill, NY 12524-1791
Phone (845) 896-7730

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
I20220707002456 NY Practitioner - Physician Assistant 0143408864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Dermatology, PCGroup PAC ID 8022021732, 40 clinicians

Practice addresses (Care Compare)

40 Hurley Ave
Suite 3
Kingston, NY 12401-3738
Phone (845) 338-3200

969 Main St
Suite D
Fishkill, NY 12524-1791
Phone (845) 896-7730

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.76 of 100Reported as group
Quality
96.13
Promoting interoperability
100
Improvement activities
40
Cost
79.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
028346NYMDDermatology Physician
20851CAMDSpeech-Language Pathologist

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

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.

Hospital & facility affiliations 2

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": "1266883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1417279035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 MAIN ST STE D",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125241791",
            "telephone_number": "845-896-7730",
            "fax_number": "845-896-7758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 MAIN ST STE D",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125241791",
            "telephone_number": "845-896-7730",
            "fax_number": "845-896-7758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "ADAM",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-23",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028346",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "028346",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishkill, NY

Sources for this page

Verify at the official NPI Registry.