Active NPI
Jerrold Young, MD
- Surgery Physician
- South Miami, FL
National Provider Identifier
1104867126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- ME21428
- Practice address
- 6200 Sunset Dr
Suite 501
South Miami, FL 33143-4828 - Phone
- (305) 667-7878
- Fax
- (305) 667-7459
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | ME21428 | FL | Primary |
Addresses
Primary practice location
6200 Sunset Dr
Suite 501
South Miami, FL 33143-4828
Mailing address
6200 Sunset Dr
Suite 501
South Miami, FL 33143-4828
Phone (305) 667-7878
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 78188A | Other | FL | INDIVIDUAL MEDICARE PTAN |
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 Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Florida Surgical Group | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Miami, FL
- NPI 1447390604
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355788800000",
"number": "1104867126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6200 SUNSET DR",
"address_2": "SUITE 501",
"city": "SOUTH MIAMI",
"state": "FL",
"postal_code": "331434828",
"telephone_number": "305-667-7878",
"fax_number": "305-667-7459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6200 SUNSET DR",
"address_2": "SUITE 501",
"city": "SOUTH MIAMI",
"state": "FL",
"postal_code": "331434828",
"telephone_number": "305-667-7878",
"fax_number": "305-667-7459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "JERROLD",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2012-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "ME21428",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIVIDUAL MEDICARE PTAN",
"identifier": "78188A",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.