Individual provider Active NPI

Ethan James Young, D.O.

  • Emergency Medicine Physician
  • Chippewa Falls, WI
National Provider Identifier
1053792895
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
73154-21 Issued in WI
Practice address
2661 County Highway I
Chippewa Falls, WI 54729-5407
Phone
(715) 723-1811
NPI assigned
Jun 17, 2015
Last updated
Mar 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101021818 MI
Emergency Medicine Physician 207P00000X S0411 TX
Emergency Medicine Physician 207P00000X 73154-21 WI Primary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X S0411 TX
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 73154-21 WI

Addresses

Primary practice location

2661 County Highway I
Chippewa Falls, WI 54729-5407

Mailing address

900 W Clairemont Ave
Eau Claire, WI 54701-6122

Other practice location 1

900 W Clairemont Ave
Eau Claire, WI 54701-6122
Phone (715) 717-4222

Other practice location 2

600 Highland Ave
Madison, WI 53792-5407
Phone (608) 263-3258

Other practice location 3

2116 Craig Rd
Eau Claire, WI 54701-6149
Phone (715) 858-4500

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address eyoung1279495@direct.uwhealth.org
Direct Messaging Address eyoung288711@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20200707000225 WI Practitioner - Emergency Medicine 2567723554 Reassigns benefits to 12 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Black River Health IncGroup PAC ID 3173431178, 62 clinicians

Practice addresses (Care Compare)

711 W Adams St
Black River Falls, WI 54615-5052
Phone (715) 284-5361

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.85 of 100Reported as group
Quality
89.04
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S0411TXMDEmergency Medicine Physician
73154-21WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Black River Health Inc CurrentSince Apr 20, 2025 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Nov 1, 2022 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Nov 1, 2022 Accepting new patients
Black River Health Inc CurrentSince Apr 20, 2025 Accepting new patients
Kalamazoo Acute Care Specialists PLC Emergency Medical Services Past Accepting new patients

Locations

711 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-3604

900 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 717-4121

4602 Eastpark Blvd
Madison, WI 53718
Phone (608) 263-7540

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

Interoperability endpoints

  • Direct secure messaging: eyoung1279495@direct.uwhealth.org
  • Direct secure messaging: eyoung288711@ewd.direct.hshs.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 2

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": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1053792895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W CLAIREMONT AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2661 COUNTY HIGHWAY I",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547295407",
            "telephone_number": "715-723-1811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 W Clairemont Ave",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547016122",
            "country_code": "US",
            "telephone_number": "715-717-4222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537925407",
            "country_code": "US",
            "telephone_number": "608-263-3258",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2116 Craig Rd",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547016149",
            "country_code": "US",
            "telephone_number": "715-858-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ETHAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101021818",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S0411",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "73154-21",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "S0411",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WI",
            "license": "73154-21",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eyoung1279495@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "600 Highland Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537925407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eyoung288711@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "2661 County Highway I",
            "city": "Chippewa Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547295407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chippewa Falls, WI

Sources for this page

Verify at the official NPI Registry.