Individual provider Active NPI

Connor Young

  • Optometrist
  • Prescott, AZ
National Provider Identifier
1023901782
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-002871 Issued in AZ
Practice address
3192 Willow Creek Rd
Prescott, AZ 86301-6610
Phone
(928) 445-1234
NPI assigned
Jun 2, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT-002871 AZ Primary

Addresses

Primary practice location

3192 Willow Creek Rd
Prescott, AZ 86301-6610

Mailing address

18581 E Strawberry Dr
Queen Creek, AZ 85142-3535

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250813003484 AZ Practitioner - Optometry 4082112412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwestern Eye Center LTDGroup PAC ID 1850296989, 116 clinicians

Practice addresses (Care Compare)

3192 Willow Creek Rd
Prescott, AZ 86301-6610
Phone (928) 445-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Eye Center, LTD Optometrist CurrentSince Jun 1, 2025 Accepting new patients
Southwestern Eye Center LTD CurrentSince Jun 1, 2025 Accepting new patients

Locations

3003 Highway 95
Ste 63
Bullhead City, AZ 86442
Phone (928) 763-7555

399 W Palomino Rd
Chino Valley, AZ 86323
Phone (928) 636-5504

270 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-4202

4760 E Falcon Dr
Ste 101
Mesa, AZ 85215
Phone (480) 985-7400

3192 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 445-1234

3223 N Windsong Dr
Prescott Vly, AZ 86314
Phone (928) 772-1510

63 S Rockford Dr
Ste 220
Tempe, AZ 85288

5632 E 5th St
Tucson, AZ 85711
Phone (520) 584-8888

2149 W 24th St
Yuma, AZ 85364
Phone (928) 726-1100

Interoperability endpoints

  • Direct secure messaging: connor.young.p20@direct.avp.nextgenshare.com

Organizations & group practices 2

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": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1023901782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18581 E STRAWBERRY DR",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851423535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3192 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863016610",
            "telephone_number": "928-445-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "CONNOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.