Michael Owen Young, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002134A Issued in IN

Practice address

6424 W Jefferson Blvd
Suite a
Fort Wayne, IN 46804-6204

Phone

(260) 436-7530

Fax

(260) 436-2698

NPI assigned

Nov 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Michael O Young OD PC

  • Optometrist
  • Fort Wayne, IN
  • NPI 1487724258
  NPD (past) Authorized official
• Alvarez Vision Services Inc

  • Optometrist
  • Loogootee, IN
  • NPI 1245439140
  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1043380819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6424 W JEFFERSON BLVD",
            "address_2": "SUITE A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046204",
            "telephone_number": "260-436-7530",
            "fax_number": "260-436-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6424 W JEFFERSON BLVD",
            "address_2": "SUITE A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046204",
            "telephone_number": "260-436-7530",
            "fax_number": "260-436-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MICHAEL",
        "middle_name": "OWEN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002134A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "18808",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "IN2134",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Paige Young
• Heather Young, RBT
• Jessica Young, PHARMD
• Leslie Dionne Young
• Linda Ann Young, MS
• Olivia Lyn Young
• Sally Ann Young, A.T.C.-L
• Sydney Young, RBT, BS
• William F. Young, M.D.
• Gary Younghans, MFT

• Optometrist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.