Individual provider Active NPI

Douglas Howard Payne, CRNA

  • Certified Registered Nurse Anesthetist
  • Melbourne, FL
National Provider Identifier
1942244124
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9283899 Issued in FL
Practice address
1350 Hickory St
Melbourne, FL 32901-3224
Phone
(321) 434-7000
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 168953 NC
Certified Registered Nurse Anesthetist 367500000X 168953 NC
Certified Registered Nurse Anesthetist 367500000X ARNP9283899 FL Primary

Addresses

Primary practice location

1350 Hickory St
Melbourne, FL 32901-3224

Mailing address

407 Highway A1A Apt 452
Satellite Beach, FL 32937-2329
Phone (910) 792-0199

Other identifiers 1

IdentifierTypeStateIssuer
000674900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090126000139 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284696907 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brevard Physician Associates PLLCGroup PAC ID 1850535048, 221 clinicians

Practice addresses (Care Compare)

1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
168953NCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Physician Associates, PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2013 Accepting new patients
Lovelock Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 3, 2022 Accepting new patients
North American Partners in Anesthesia (Virginia), LLC Past Accepting new patients
Metropolitan Anesthesia, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Milford Anesthesia Associates LLC Nurse Anesthetist, Certified Registered PastSince Sep 25, 2019 Accepting new patients
The Stingl Family Foundation, Inc PastSince May 7, 2016 Accepting new patients
Brevard Anesthesia Services PA Registered Nurse PastSince Dec 1, 1999 Accepting new patients
Coastal Anesthesia Associates, PA Past Accepting new patients
Martinsville Anesthesia, PC Past Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

95 Bulldog Blvd
Ste 104
Melbourne, FL 32901
Phone (321) 952-9800

520 E Strawbridge Ave
Melbourne, FL 32901

220 N Sykes Creek Pkwy
Ste 101
Merritt Island, FL 32953
Phone (321) 452-9799

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1942244124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 HIGHWAY A1A APT 452",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329372329",
            "telephone_number": "910-792-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 HICKORY ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013224",
            "telephone_number": "321-434-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "DOUGLAS",
        "middle_name": "HOWARD",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "168953",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "168953",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9283899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000674900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.