Individual provider Active NPI

Martha Catalina Payne, D. M.D.

  • General Practice Dentistry
  • Santa Cruz, CA
National Provider Identifier
1841507084
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
59792 Issued in CA
Practice address
620 Frederick St
Santa Cruz, CA 95062-2203
Phone
(831) 457-0343
NPI assigned
Sep 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 59792 CA Primary

Addresses

Primary practice location

620 Frederick St
Santa Cruz, CA 95062-2203

Mailing address

620 Frederick St
Santa Cruz, CA 95062-2203
Phone (831) 457-0343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161222000945 CA Order and Referring Only - DentistPractitioner - Dentist 0042591422

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Martha C. Payne DMD Inc CurrentSince Mar 1, 2020 Accepting new patients
Payne Dental Corporation PastSince Jul 28, 2019 Accepting new patients
Anthony Yen DMD Inc. PastSince Mar 13, 2022 Accepting new patients

Locations

620 Frederick St
Santa Cruz, CA 95062
Phone (831) 457-0343

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1841507084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 FREDERICK ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950622203",
            "telephone_number": "831-457-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 FREDERICK ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950622203",
            "telephone_number": "831-457-0343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "MARTHA",
        "middle_name": "CATALINA",
        "credential": "D. M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-09",
        "last_updated": "2022-03-07",
        "certification_date": "2021-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.