Active NPI
William D Payne, MD
- Surgery Physician
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 22417
- Practice address
- 516 Delaware Street SE
PWB Second Floor, Clinic 2a
Minneapolis, MN 55455 - Phone
- (612) 626-6100
- NPI assigned
- Sep 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 22417 | MN | Primary |
| Vascular Surgery Physician | 2086S0129X | 22417 | MN |
Addresses
Primary practice location
516 Delaware Street SE
PWB Second Floor, Clinic 2a
Minneapolis, MN 55455
Mailing address
420Delaware Street SE, MMD 292
University of Minnesota Physicians
Minneapolis, MN 55455
Phone (612) 626-6100
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37-12454 | Other | MN | MEDICA CHOICE |
| 604794 | Other | MN | ARAZ |
| 082982 | Other | MN | FAIRVIEW |
| 1009266 | Other | MN | PREFERRED ONE |
| HP22196 | Other | MN | HEALTH PARTNERS |
| 084587600 | Medicaid | MN | |
| 17-00026 | Other | MN | MEDICA PRIMARY |
| 2T102PA | Other | MN | BLUE CROSS BLUE SHIELD |
| 101592 | Other | MN | UCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22417 | MN | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients |
Locations
909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383
516 Delaware St SE
Fl Second
Minneapolis, MN 55455
Phone (612) 626-6100
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1053952606
-
- General Practice Physician
- Edina, MN
- NPI 1831707207
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351209600000",
"number": "1689779993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420DELAWARE STREET SE, MMD 292",
"address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55455",
"telephone_number": "612-626-6100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 DELAWARE STREET SE",
"address_2": "PWB SECOND FLOOR, CLINIC 2A",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55455",
"telephone_number": "612-626-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAYNE",
"first_name": "WILLIAM",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2012-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MN",
"license": "22417",
"primary": true
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "MN",
"license": "22417",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA CHOICE",
"identifier": "37-12454",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ",
"identifier": "604794",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FAIRVIEW",
"identifier": "082982",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "1009266",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP22196",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "084587600",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA PRIMARY",
"identifier": "17-00026",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "2T102PA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "101592",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.