NPIMap

Individual provider Active NPI

Kristine L Young, PA-C

  • Medical Physician Assistant
  • Oak Harbor, WA
National Provider Identifier
1033109772
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA10005064 Issued in WA
Practice address
275 SE Cabot Dr
Suite B101
Oak Harbor, WA 98277-3715
Phone
(360) 675-6648
Fax
(360) 679-2487
NPI assigned
Oct 25, 2005
Last updated
Apr 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110004268 VA
Medical Physician Assistant 363AM0700X PA10005064 WA Primary

Addresses

Primary practice location

275 SE Cabot Dr
Suite B101
Oak Harbor, WA 98277-3715

Mailing address

275 SE Cabot Dr
Suite B101
Oak Harbor, WA 98277-3715
Phone (360) 675-6648

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061027000373 WA Practitioner - Physician Assistant 2163429598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Whidbey Island Public Hospital DistrictGroup PAC ID 1658280680, shared by 13 NPIs, 100 clinicians
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1300 NE Goldie St
Oak Harbor, WA 98277-4832

2600 Compass Rd
Glenview, IL 60026-8001

275 SE Cabot Dr
Oak Harbor, WA 98277-3740
Phone (360) 675-6648

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10005064WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Whidbey Island Public Hospital District Physician Assistant CurrentSince Jan 1, 2014 Accepting new patients
WGH Primary Care Associates, P.S. Current Accepting new patients
Whidbey Island Public Hospital District CurrentSince Jan 1, 2014 Accepting new patients
Whidbey Island Public Hospital District Past Accepting new patients
Internal Medicine of Newton Co Past Accepting new patients
Whidbey Island Public Hospital District Past Accepting new patients

Locations

205 S Main St
Ste A
Coupeville, WA 98239
Phone (360) 240-4013

5486 Harbor Ave
Freeland, WA 98249
Phone (360) 331-5060

275 SE Cabot Dr
Ste B101
Oak Harbor, WA 98277
Phone (360) 675-6648

Interoperability endpoints

  • Direct secure messaging: kristine.young@wh.jhie.net

Organizations & group practices 7

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

Hospital & facility affiliations 10

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": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1033109772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 SE CABOT DR",
            "address_2": "SUITE B101",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982773715",
            "telephone_number": "360-675-6648",
            "fax_number": "360-679-2487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 SE CABOT DR",
            "address_2": "SUITE B101",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982773715",
            "telephone_number": "360-675-6648",
            "fax_number": "360-679-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KRISTINE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004268",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10005064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Harbor, WA

Sources for this page

Verify at the official NPI Registry.