Individual provider Active NPI

Liesl G Young, MD

  • Pediatrics Physician
  • Centennial, CO
National Provider Identifier
1023030178
Registry record updated May 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
38578 Issued in CO
Practice address
9094 E Mineral Cir
#120
Centennial, CO 80112-7200
Phone
(303) 779-5437
Fax
(303) 689-9628
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 38578 CO Primary

Addresses

Primary practice location

9094 E Mineral Cir
#120
Centennial, CO 80112-7200

Mailing address

9094 E Mineral Cir
#120
Centennial, CO 80112-7200
Phone (303) 779-5437

Other identifiers 1

IdentifierTypeStateIssuer
57802840MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38578COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Colorado Current Accepting new patients
Pediatrics 5280 PC Pediatrics Past Accepting new patients
Pediatrics 5280, PC Pediatrics Past Accepting new patients

Locations

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

Interoperability endpoints

  • Direct secure messaging: lyoung14773@direct.childrenscolorado.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.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304640000000",
    "number": "1023030178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9094 E MINERAL CIR",
            "address_2": "#120",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801127200",
            "telephone_number": "303-779-5437",
            "fax_number": "303-689-9628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9094 E MINERAL CIR",
            "address_2": "#120",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801127200",
            "telephone_number": "303-779-5437",
            "fax_number": "303-689-9628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "LIESL",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2011-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "38578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57802840",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.