DR. RALPH R. PAYLOR MD
NPI 1407807928
Ophthalmology - Retina Specialist in Melbourne, FL

Active since May 12, 2006PECOS EnrolledAccepts Medicare Assignment
92.9/100
CMS Quality Rating
502 E NEW HAVEN AVE, MELBOURNE, FL 32901(321) 727-2020(321) 984-9547 Get Directions Write a Review

NPPES record last updated: November 8, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 8, 2021, Feb 3, 2017 (2 updates tracked since 2017).

About Dr. Ralph R. Paylor Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. RALPH R. PAYLOR MD (NPI 1407807928) is an individual retina specialist in Melbourne, Florida, licensed in Florida (ME48261) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and is a graduate of Medical University Of South Carolina College Of Medicine (1980).

NPPES Registry Identity

NPI1407807928
Entity TypeIndividualMale
Primary Taxonomy207WX0107X
Provider Legal NameDR. RALPH R. PAYLORCredential: MD
Location Address502 E NEW HAVEN AVEMelbourne, FL 32901-5427
Mailing Address502 E New Haven AveMelbourne, FL 32901-5427 · (321) 727-2020 · Fax (321) 984-9547
Fax(321) 984-9547
Sole ProprietorNo
Medical School CMSMedical University Of South Carolina College Of MedicineGraduated 1980
Enumeration DateMay 12, 2006
Last NPPES UpdateNovember 8, 20212 updates tracked since enumeration
NPPES CertifiedNovember 8, 2021
NPI 1407807928 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0107X
License Licensed in FL · ME48261
Definition
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
Also ListedOphthalmologyTaxonomy 207W00000X · License ME48261 (FL)
502 E NEW HAVEN AVE, Melbourne, FL 32901

Other Identifiers 8

Other166528FL · Ccn
Medicaid043955000FL
Other2714301003FL · Cigna
Other4038998FL · Aetna Ppo
Other05598FL · Blue Cross/blue Shield
Other180032670FL · Railroad Medicare
Other2000387FL · Aetna Hmo
Other706303FL · First Health

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Ralph R. Paylor Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6507891850
PECOS Enrollment IDI20100723000081
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, faricimab-svoa, 0.1 mg J2777
Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.
8,880 services31 patients
Injection, aflibercept, 1 mg J0178
Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.
1,446 services119 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
1,342 services367 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
1,269 services249 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
635 services391 patients
Injection, ranibizumab, 0.1 mg J2778
Ranibizumab is a medication given via injection to treat certain eye conditions like age-related macular degeneration. It works by slowing vision loss and in some cases, improving vision by blocking abnormal blood vessel growth in the eye.
485 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.9/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Promoting Interoperability100
Improvement Activities40
Cost76.33

Reported Quality Measures

Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation for…
96%522 patients4/55-star benchmark: 100%
Age-Related Macular Degeneration (AMD): Dilated Macular Examination
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or…
94%521 patients4/55-star benchmark: 100%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
95%432 patients4/55-star benchmark: 100%
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus…
88%223 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
92%2,207 patients4/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
90%30 patients4/55-star benchmark: 98%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
97%3,803 patients4/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
83%52 patients4/55-star benchmark: 100%
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months
99%246 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
97%3,803 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Optometrist
502 E NEW HAVEN AVE
MELBOURNE, FL 32901
Ophthalmology
502 E NEW HAVEN AVE
MELBOURNE, FL 32901
Optometrist
502 E NEW HAVEN AVE
MELBOURNE, FL 32901
Ophthalmology
502 E NEW HAVEN AVE
MELBOURNE, FL 32901
Ophthalmology
502 E NEW HAVEN AVE
MELBOURNE, FL 32901
Ophthalmology (Cornea and External Diseases Specialist)
502 E NEW HAVEN AVE
MELBOURNE, FL 32901
Optometrist
502 E NEW HAVEN AVE
MELBOURNE, FL 32901
Ophthalmology (Glaucoma Specialist)
502 E NEW HAVEN AVE
MELBOURNE, FL 32901

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 Ralph Paylor's NPI number?

The NPI number for Ralph Paylor is 1407807928. It was assigned to this individual provider in the NPPES registry on May 12, 2006.

Where is Ralph Paylor located?

Ralph Paylor practices at 502 E New Haven Ave, Melbourne, FL 32901. The listed phone number is (321) 727-2020.

What is Ralph Paylor's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Is Ralph Paylor enrolled in Medicare?

Yes. Ralph Paylor is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Ralph Paylor accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Health First Commercial Plans, Inc. and UnitedHealthcare list Ralph Paylor as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ralph Paylor was last updated on November 8, 2021. 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.