Tylor Scott Payne, CAA is a medicare enrolled "Anesthesiologist Assistant" in Joplin, Missouri. His current practice location is
1102 W 32nd St, Joplin, Missouri. You can reach out to his office (for appointments etc.) via phone at
(417) 347-1111.
Tylor Scott Payne is licensed to practice in Wisconsin (license number 32698366) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1538873807.
Provider's Profile
| Full Name | Tylor Scott Payne |
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| Gender | Male |
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| Speciality | Anesthesiologist Assistant |
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| Location | 1102 W 32nd St, Joplin, Missouri |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1538873807
- Provider Enumeration Date: 01/10/2023
- Last Update Date: 04/10/2024
Medicare PECOS Information:
- PECOS PAC ID: 2062883275
- Enrollment ID: I20230126001933
Medical Identifiers
Medical identifiers for Tylor Scott Payne such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1538873807 | NPI | - | NPPES |
| 095200125 | Other | IN | MEDICARE PTAN |
| 1102822179 | Other | IN | ANTHEM PTAN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 367H00000X | Anesthesiologist Assistant | 32698366 (Wisconsin) | Primary |
| 367H00000X | Anesthesiologist Assistant | 75000128A (Indiana) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Tylor Scott Payne allows following entities to bill medicare on his behalf.
| Entity Name | Freeman-oak Hill Health System |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1679517023
PECOS PAC ID: 8325942253
Enrollment ID: O20040218000570 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tylor Scott Payne is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Tylor Scott Payne, CAA
250 N Shadeland Ave,
Indianapolis, IN 46219-4959
Ph: () - | Tylor Scott Payne, CAA
1102 W 32nd St,
Joplin, MO 64804-3503
Ph: (417) 347-1111 |
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