JACK ANDREW PAYNE PA-C
NPI 1548021801
Physician Assistant in Summerville, SC

Q: What is Jack Payne's NPI number?

The NPI number for Jack Payne is 1548021801. It was assigned to this individual provider in the NPPES registry on January 23, 2024.

Q: What is Jack Payne's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Payne was last updated on January 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.

Active since January 23, 2024PECOS EnrolledAccepts Medicare Assignment

300 CALLEN BLVD STE 330, SUMMERVILLE, SC 29486(843) 763-2857(843) 606-8053 Get Directions Write a Review

NPPES record last updated: January 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jack Andrew Payne Pa-c NPPES

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

JACK ANDREW PAYNE PA-C (NPI 1548021801) is an individual physician assistant in Summerville, South Carolina, licensed in South Carolina (5179) and active in the NPI registry since January 2024. He is enrolled in Medicare PECOS, is affiliated with Trident Medical Center, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1548021801

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameJACK ANDREW PAYNECredential: PA-C

Location Address300 CALLEN BLVD STE 330Summerville, SC 29486-2816

Mailing AddressPo Box 751649Charlotte, NC 28275-1649 · (888) 472-0043 · Fax (843) 724-2440

Phone(843) 763-2857

Fax(843) 606-8053

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateJanuary 23, 2024

Last NPPES UpdateJanuary 13, 2026

NPPES CertifiedJanuary 13, 2026

✔ NPI 1548021801 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in SC · 5179

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

300 CALLEN BLVD STE 330, Summerville, SC 29486

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, First Choice Next and more.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

Jack Andrew Payne Pa-c 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 ID3274976949

PECOS Enrollment IDI20240209000726

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 9

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

284 services140 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

60 services43 patients

Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes G0446

This is a yearly, personal consultation focused on behaviors affecting heart health. It lasts 15 minutes and may cover topics like diet, exercise, and stress management. It's about learning healthy habits to protect your heart.

32 services32 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

27 services26 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

25 services25 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

22 services22 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Trident Medical Center

Acute Care Hospitals · Charleston, SC

3/5 CMS rating

OwnershipProprietary

CMS Certification Number420079

Location9330 Medical Plaza DrCharleston, SC 29406 · Charleston County

Emergency services Birthing friendly

Roper St Francis Hospital-Berkeley Inc

Acute Care Hospitals · Summerville, SC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420110

Location300 Callen BlvdSummerville, SC 29486 · Dorchester County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29486 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

$83.18 typical visit price

range $53.57 – $163.84

Typical copayment $20.79 (range $13.39 – $40.96)

Most-billed visit code 99203

Established Patient

$67.12 typical visit price

range $16.96 – $133.52

Typical copayment $16.78 (range $4.24 – $33.38)

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.

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.

SHAYLA BRIANNA SMART PA-C

Physician Assistant (Surgical)