Individual provider Active NPI

Susan D Payne, MD

  • Obstetrics & Gynecology Physician
  • Portland, OR
National Provider Identifier
1508891805
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD22667 Issued in OR
Practice address
9427 SW Barnes Rd
Suite 395
Portland, OR 97225-6652
Phone
(503) 216-2602
Fax
(503) 216-2639
NPI assigned
Jul 12, 2006
Last updated
Jan 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD22667 OR Primary

Addresses

Primary practice location

9427 SW Barnes Rd
Suite 395
Portland, OR 97225-6652

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other identifiers 1

IdentifierTypeStateIssuer
288134MedicaidOR

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address spayne102746@oc.providencedirect.org
Direct Messaging Address spayne102746@oc.providencedirect.org
Direct Messaging Address spayne102746@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20100623000413 OR Practitioner - Obstetrics/Gynecology 0143351973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of California, Irvine, California College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

7305 SE Circuit Dr
Suite 260
Hillsboro, OR 97129-1966
Phone (503) 342-9928

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD22667ORMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Dec 5, 2013 Accepting new patients
Providence Health & Services Oregon CurrentSince Dec 5, 2013 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

7305 SE Circuit Dr
Ste 260
Hillsboro, OR 97129
Phone (503) 342-9928

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

9135 SW Barnes Rd
Ste 761
Portland, OR 97225
Phone (503) 216-2602

9427 SW Barnes Rd
Ste 395
Portland, OR 97225
Phone (503) 216-2602

960 N 16th St
Ste 304
Springfield, OR 97477
Phone (541) 744-6172

18040 SW Lower Boones Ferry Rd
Ste 207
Tigard, OR 97224
Phone (503) 216-5380

Interoperability endpoints

  • Direct secure messaging: spayne102746@oc.providencedirect.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1508891805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494",
            "fax_number": "503-215-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9427 SW BARNES RD",
            "address_2": "SUITE 395",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256652",
            "telephone_number": "503-216-2602",
            "fax_number": "503-216-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "SUSAN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD22667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288134",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spayne102746@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9427 SW Barnes Rd",
            "address_2": "Suite 395",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256652",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spayne102746@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "18040 SW Lower Boones Ferry Rd Ste 207",
            "city": "Tigard",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972247259",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spayne102746@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9135 SW Barnes Rd Ste 761",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.