Individual provider Active NPI

Mason Payne, MD

  • Family Medicine Physician
  • Fredericksburg, TX
National Provider Identifier
1417694035
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
V2212 Issued in TX
Practice address
514 W Windcrest St
Fredericksburg, TX 78624-4633
Phone
(830) 977-0330
NPI assigned
May 16, 2022
Last updated
Jul 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X V2212 TX Primary

Addresses

Primary practice location

514 W Windcrest St
Fredericksburg, TX 78624-4633

Mailing address

514 W Windcrest St
Fredericksburg, TX 78624-4633
Phone (830) 977-0330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250813000084 TX Practitioner - Family Practice 1456731538 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas at Austin Dell Medical School, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

514 W Windcrest St
Fredericksburg, TX 78624-4633
Phone (830) 997-0330

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fredericksburg Family Clinic PA Family Medicine CurrentSince Aug 1, 2025 Accepting new patients
DCS Medical PA CurrentSince Oct 10, 2025 Accepting new patients
DCS Medical PA CurrentSince Oct 10, 2025 Accepting new patients
Fredericksburg Family Clinic PA Family Medicine CurrentSince Aug 1, 2025 Accepting new patients

Locations

1115 E Tyler St
Athens, TX 75751
Phone (903) 292-5015

3201 University Dr E
Ste 135
Bryan, TX 77802
Phone (979) 703-1832

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, 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": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1417694035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 W WINDCREST ST",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244633",
            "telephone_number": "830-977-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 W WINDCREST ST",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244633",
            "telephone_number": "830-977-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "MASON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-16",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "V2212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, TX

Sources for this page

Verify at the official NPI Registry.