Individual provider Active NPI

Mark E Young, MD

  • Family Medicine Physician
  • Sidney, OH
National Provider Identifier
1013010313
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3583349 Issued in OH
Practice address
430 4TH Ave Ste 3
Sidney, OH 45365-1100
Phone
(937) 492-7797
Fax
(937) 710-9040
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3583349 OH Primary

Addresses

Primary practice location

430 4TH Ave Ste 3
Sidney, OH 45365-1100

Mailing address

430 4TH Ave Ste 3
Sidney, OH 45365-1100
Phone (937) 492-7797

Other identifiers 2

IdentifierTypeStateIssuer
2435930MedicaidOH
000000305508OtherANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031223000889 OH Practitioner - Family Practice 5496653644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rutgers New Jersey Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

430 4TH Ave
Suite 3
Sidney, OH 45365-1100
Phone (937) 492-7797

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3583349OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Young Family Medicine, Inc. Family Medicine CurrentSince Apr 28, 2009 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

300 3rd Ave
Ste A
Sidney, OH 45365

430 4th Ave
Ste 3
Sidney, OH 45365
Phone (937) 492-3245

300 3rd Ave
Sidney, OH 45365
Phone (937) 710-4786

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 2

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": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1013010313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 4TH AVE STE 3",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453651100",
            "telephone_number": "937-492-7797",
            "fax_number": "937-710-9040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 4TH AVE STE 3",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453651100",
            "telephone_number": "937-492-7797",
            "fax_number": "937-710-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MARK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "3583349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2435930",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000305508",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sidney, OH

Sources for this page

Verify at the official NPI Registry.