Individual provider Active NPI

Jacob N Young, MD

  • Neurological Surgery Physician
  • Charlottesville, VA
National Provider Identifier
1043312648
Registry record updated Mar 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
0101049336 Issued in VA
Practice address
500 Martha Jefferson Dr FL 4
Charlottesville, VA 22911-4668
Phone
(434) 654-8960
Fax
(434) 654-8962
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 0101049336 VA Primary

Addresses

Primary practice location

500 Martha Jefferson Dr FL 4
Charlottesville, VA 22911-4668

Mailing address

PO Box 79777
Baltimore, MD 21279-0777
Phone (434) 654-7794

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20100519000167 VA Practitioner - Neurosurgery 1254353162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Duke University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martha Jefferson Medical Group LLCGroup PAC ID 5991889081, 197 clinicians

Practice addresses (Care Compare)

500 Martha Jefferson Dr
Charlottesville, VA 22911-4668
Phone (434) 654-8960

Hospital & facility affiliations

  • Sentara Martha Jefferson Hospital Hospital, Charlottesville, VA, CCN 490077

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion63
Laminectomy or laminotomy (partial removal of spine bones)35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101049336VAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martha Jefferson Medical Group LLC Neurological Surgery CurrentSince Apr 19, 2010 Accepting new patients
Martha Jefferson Hospital PastSince Apr 19, 2010 Accepting new patients
Neurosurgical Consultants of Washington Inc. PS Neurological Surgery Past Accepting new patients
Neurosurgical Consultants of Washington, Inc P S Neurological Surgery Past Accepting new patients

Locations

500 Martha Jefferson Dr
Ste 415B
Charlottesville, VA 22911
Phone (434) 654-8960

500 Martha Jefferson Dr
#415A
Charlottesville, VA 22911
Phone (434) 654-8960

1646 Park Ridge Dr
Crozet, VA 22932
Phone (434) 654-2760

Interoperability endpoints

  • Direct secure messaging: jyoung246290@direct.sentara.net

Organizations & group practices 4

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520899200000",
    "number": "1043312648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79777",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212790777",
            "telephone_number": "434-654-7794",
            "fax_number": "434-654-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARTHA JEFFERSON DR FL 4",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114668",
            "telephone_number": "434-654-8960",
            "fax_number": "434-654-8962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JACOB",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2018-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "VA",
            "license": "0101049336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.