NPIMap

Individual provider Active NPI

Paul Edward Young

  • Physician Assistant
  • Boulder, CO
National Provider Identifier
1073652178
Registry record updated Nov 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0002387 Issued in CO
Practice address
1100 Balsam Ave
Boulder, CO 80304-3404
Phone
(303) 440-2037
Fax
(303) 306-7753
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0002387 CO Primary

Addresses

Primary practice location

1100 Balsam Ave
Boulder, CO 80304-3404

Mailing address

PO Box 173894
Denver, CO 80217-3894
Phone (303) 306-7783

Other identifiers 1

IdentifierTypeStateIssuer
40589528MedicaidCO

Other names 1

  • Paul E. Young Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20200227000373 KS Practitioner - Physician Assistant 9931291614 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goodland Regional Medical CenterGroup PAC ID 3375535263, 22 clinicians
Rawlins County Health CenterGroup PAC ID 4688585151, shared by 4 NPIs, 9 clinicians

Practice addresses (Care Compare)

106 Willow Rd
Goodland, KS 67735-1518
Phone (785) 890-6012

220 W 2ND St
Goodland, KS 67735-1602
Phone (785) 890-6012

707 Grant St
Atwood, KS 67730-1526
Phone 78562632112205

Hospital & facility affiliations

  • L & C Home Health Agency Inc Home health agency, Colby, KS, CCN 178055
  • Rawlins County Health Center Hospital, Atwood, KS, CCN 171307
  • Goodland Regional Medical Center Hospital, Goodland, KS, CCN 171370
  • Citizens Medical Center Hospital, Colby, KS, CCN 171362
  • Rawlins County Health Center Nursing home, CCN 17Z307

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Goodland Regional Medical Center CurrentSince Dec 23, 2019 Accepting new patients
Rawlins County Health Center CurrentSince Jan 1, 2021 Accepting new patients
Rawlins County Health Center Current Accepting new patients
Rawlins County Health Center CurrentSince Jan 1, 2021 Accepting new patients
Goodland Regional Medical Center CurrentSince Dec 23, 2019 Accepting new patients
Rawlins County Health Center Past Accepting new patients
Goodland Regional Medical Center Past Accepting new patients
Boulder Community Health Past Accepting new patients
Apex Emergency Group, Inc Past Accepting new patients

Locations

707 Grant St
Atwood, KS 67730
Phone (785) 626-3211

106 Willow Rd
Goodland, KS 67735
Phone (785) 890-6012

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13372/brand/1/csg/1/fhir/r4
  • Direct secure messaging: paul.young.1@13372.direct.athenahealth.com
  • Direct secure messaging: paul.young.1@17074.direct.athenahealth.com

Organizations & group practices 9

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 5

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1073652178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 173894",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802173894",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BALSAM AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043404",
            "telephone_number": "303-440-2037",
            "fax_number": "303-306-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "PAUL",
        "middle_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0002387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40589528",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAUL",
            "last_name": "YOUNG",
            "middle_name": "E.",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.