Individual provider Active NPI

Melissa Ann Young, NP

  • Pediatric Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1104191402
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
71003910A Issued in IN
Practice address
705 Riley Hospital Dr
Ste 4230
Indianapolis, IN 46202-5109
Phone
(317) 944-7888
Fax
(317) 944-7481
NPI assigned
Mar 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 71003910A IN Primary
Registered Nurse 163W00000X 28157102A IN

Addresses

Primary practice location

705 Riley Hospital Dr
Ste 4230
Indianapolis, IN 46202-5109

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Other identifiers 2

IdentifierTypeStateIssuer
000000765661OtherINANTHEM PIN
201065710MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address myoung1@direct.iuhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140207000299 IN Practitioner - Nurse Practitioner 5092944363 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28157102AINMDRegistered Nurse
71003910AINMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Apr 1, 2025 Accepting new patients
University Family Physicians, Inc. CurrentSince Oct 1, 2016 Accepting new patients
University Urologists, Inc., PC Pediatrics CurrentSince Nov 20, 2013 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince Feb 21, 2015 Accepting new patients
University Family Physicians, Inc. CurrentSince Oct 1, 2016 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

7614 Solutions Ctr
Chicago, IL 60677

7216 Solutions Ctr
Chicago, IL 60677

5208 Reliable Pkwy
Chicago, IL 60686

11725 Illinois St
Ste 520
Carmel, IN 46032
Phone (317) 688-5189

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

575 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 944-3966

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

705 Riley Hospital Dr
Ste 4230
Indianapolis, IN 46202
Phone (317) 948-8556

Organizations & group practices 7

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": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1104191402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR",
            "address_2": "STE 4230",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-944-7888",
            "fax_number": "317-944-7481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "888-484-3258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-20",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71003910A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28157102A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000765661",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201065710",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "myoung1@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "705 Riley Hospital Dr",
            "address_2": "STE 4230",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.