Individual provider Active NPI

Nicole Ann Young, PA

  • Physician Assistant
  • Germantown, MD
National Provider Identifier
1003654971
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
19801 Observation Dr
Germantown, MD 20876-4070
Phone
(301) 557-6000
NPI assigned
Jul 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

19801 Observation Dr
Germantown, MD 20876-4070

Mailing address

19801 Observation Dr
Germantown, MD 20876-4070
Phone (301) 557-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241114003355 DC Practitioner - Physician Assistant 0244764140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Services of Holy CrossGroup PAC ID 3779516992, 159 clinicians

Practice addresses (Care Compare)

1500 Forest Glen Rd
Silver Spring, MD 20910-1460
Phone (301) 754-7000

19801 Observation Dr
Germantown, MD 20876-4070
Phone (301) 557-6000

Hospital & facility affiliations

  • Holy Cross Germantown Hospital Hospital, Germantown, MD, CCN 210065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Services of Holy Cross CurrentSince Nov 5, 2024 Accepting new patients
Professional Services of Holy Cross Physician Assistant CurrentSince Nov 5, 2024 Accepting new patients
Rochester General Hospital PastSince Jul 1, 2024 Accepting new patients

Locations

19801 Observation Dr
Germantown, MD 20876
Phone (301) 557-5928

1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230

Interoperability endpoints

  • Direct secure messaging: nyoung3838739@direct.trinity-health.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1003654971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19801 OBSERVATION DR",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208764070",
            "telephone_number": "301-557-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19801 OBSERVATION DR",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208764070",
            "telephone_number": "301-557-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

Verify at the official NPI Registry.