Individual provider Active NPI

Brian D Young, DO

  • Internal Medicine Physician
  • Macomb, MI
National Provider Identifier
1093769192
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
BY013152 Issued in MI
Practice address
46857 Garfield Rd
Macomb, MI 48044-5225
Phone
(586) 532-8500
Fax
(586) 532-1515
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BY013152 MI Primary

Addresses

Primary practice location

46857 Garfield Rd
Macomb, MI 48044-5225

Mailing address

37399 Garfield Rd Ste 106
Clinton TWP, MI 48036-3672
Phone (586) 226-3500

Other identifiers 1

IdentifierTypeStateIssuer
1093769192MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BY013152MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pulsar Medical Group PC Internal Medicine Past Accepting new patients
Macomb Internists PC Internal Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1093769192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37399 GARFIELD RD STE 106",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480363672",
            "telephone_number": "586-226-3500",
            "fax_number": "586-226-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46857 GARFIELD RD",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480445225",
            "telephone_number": "586-532-8500",
            "fax_number": "586-532-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "BRIAN",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "BY013152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093769192",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.