Individual provider Active NPI

Dominque S Young, PA-C

  • Physician Assistant
  • Pittsburgh, PA
National Provider Identifier
1104656479
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA065677 Issued in PA
Practice address
200 Lothrop St
Pittsburgh, PA 15213-2536
Phone
(814) 322-6048
NPI assigned
Aug 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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 MA065677 PA Primary

Addresses

Primary practice location

200 Lothrop St
Pittsburgh, PA 15213-2536

Mailing address

3124 Glendale Ave
Pittsburgh, PA 15227-2829
Phone (412) 418-4149

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dominque.s.young@upmcdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20241008001198 PA Practitioner - Physician Assistant 2264963792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Pittsburgh PhysiciansGroup PAC ID 8729990239, 4,166 clinicians

Practice addresses (Care Compare)

200 Lothrop St
Pittsburgh, PA 15213-2536

200 Lothrop St
Pittsburgh, PA 15213-2546
Phone (412) 383-1370

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA065677PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince Oct 7, 2024 Accepting new patients
University of Pittsburgh Physicians CurrentSince Oct 7, 2024 Accepting new patients
Upmc Emergency Medicine Inc Past Accepting new patients

Locations

200 Lothrop St
Ste B400
Pittsburgh, PA 15213
Phone (412) 647-3685

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

Organizations & group practices 4

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 4

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": "1722556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1104656479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 GLENDALE AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152272829",
            "telephone_number": "412-418-4149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LOTHROP ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152132536",
            "telephone_number": "814-322-6048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "DOMINQUE",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-02",
        "last_updated": "2024-10-23",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA065677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dominque.s.young@upmcdirect.com",
            "affiliation": "N",
            "address_1": "600 Grant St Fl 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.