SAMUEL PAYNE MD
NPI 1760122618
Student in an Organized Health Care Education/Training Program in Minneapolis, MN

Q: What is Samuel Payne's NPI number?

The NPI number for Samuel Payne is 1760122618. It was assigned to this individual provider in the NPPES registry on March 30, 2022.

Q: What is Samuel Payne's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Payne was last updated on May 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since March 30, 2022PECOS Enrolled

2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(612) 273-8383 Get Directions Write a Review

NPPES record last updated: May 13, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

On this page

About Samuel Payne Md NPPES

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

SAMUEL PAYNE MD (NPI 1760122618) is an individual student in an organized health care education/training program in Minneapolis, Minnesota and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1760122618

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameSAMUEL PAYNECredential: MD

Location Address2450 RIVERSIDE AVEMinneapolis, MN 55454-1450

Mailing Address2248 Iola StAurora, CO 80010-1242 · (720) 335-7729

Phone(612) 273-8383

Sole ProprietorNo

Enumeration DateMarch 30, 2022

Last NPPES UpdateMay 13, 2024

NPPES CertifiedMay 13, 2024

✔ NPI 1760122618 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2450 RIVERSIDE AVE, Minneapolis, MN 55454

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Payne Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

MICHELLE IRENE GRAY

Rehabilitation Practitioner