Organization Active NPI

Patty K. Young, MD, PA

  • Plastic and Reconstructive Surgery Physician
  • Plano, TX
National Provider Identifier
1073887386
Registry record updated Mar 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
H5504 Issued in TX
Legal business name
PATTY K. YOUNG, MD, PA
Practice address
4104 W 15TH St
Suite 200
Plano, TX 75093-5860
Phone
(972) 398-1131
Fax
(972) 398-0199
NPI assigned
Mar 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2012

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

Authorized official

Name
Patty Young, MDNPI 1548343452
Title
Physician Owner
Phone
(972) 398-1131

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X H5504 TX Primary

Addresses

Primary practice location

4104 W 15TH St
Suite 200
Plano, TX 75093-5860

Mailing address

4104 W 15TH St
Suite 200
Plano, TX 75093-5860
Phone (972) 398-1131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120402000590 TX Part B Supplier - Clinic/Group Practice 9739349515 Receives reassigned benefits from 1 practitioner
Practice locations: Plano, TX

National Provider Directory

National Provider Directory

Locations

4104 W 15th St
Ste 200
Plano, TX 75093
Phone (972) 398-1131

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330905600000",
    "number": "1073887386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4104 W 15TH ST",
            "address_2": "SUITE 200",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935860",
            "telephone_number": "972-398-1131",
            "fax_number": "972-398-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4104 W 15TH ST",
            "address_2": "SUITE 200",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935860",
            "telephone_number": "972-398-1131",
            "fax_number": "972-398-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATTY K. YOUNG, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-05",
        "last_updated": "2012-03-05",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "PATTY",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "972-398-1131",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "H5504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.