HOLLY DENISE PAYNE M.D.
NPI 1225399322
Pediatrics in Clifton Park, NY
About Holly Denise Payne M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HOLLY DENISE PAYNE M.D. (NPI 1225399322) is an individual pediatrics provider in Clifton Park, New York, licensed in New York (313869) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS and maintains a secondary practice location in Paducah.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Holly Denise Payne M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Holly Payne reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Troy, NY 12180
- Reassigned Medicare billing, New York enrollment
- 725 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 12065 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Holly Payne's NPI number?
The NPI number for Holly Payne is 1225399322. It was assigned to this individual provider in the NPPES registry on June 5, 2012.
Where is Holly Payne located?
Holly Payne practices at 1 Tallow Wood Dr, Clifton Park, NY 12065. The listed phone number is (518) 688-0295.
What is Holly Payne's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Holly Payne enrolled in Medicare?
Yes. Holly Payne is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Holly Payne's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Holly Payne reassigns Medicare benefits to Samaritan Hospital Of Troy, New York (Troy, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Holly Payne's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Holly Payne was last updated on January 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Holly Denise Payne, M.D. · NPI 1225399322
Pediatrics physician in Clifton Park, New York. Individual provider, active in the CMS NPPES registry since June 5, 2012.
## Identity
- **NPI:** 1225399322 (Entity type: Individual)
- **Enumerated:** June 5, 2012
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 313869 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 1 TALLOW WOOD DR, Clifton Park, NY 12065-2807
- **Phone:** (518) 688-0295
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Samaritan Hospital Of Troy, New York (NPI 1043267727, Troy, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 3, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1225399322) · Data from the CMS NPPES public registry.