Individual provider Active NPI

Daniel Trevor Young, D.O.

  • Family Medicine Physician
  • Draper, UT
National Provider Identifier
1114301710
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10997332-1204 Issued in UT
Practice address
74 E Kimballs LN Ste 300
Draper, UT 84020-5009
Phone
(801) 572-0311
NPI assigned
Jul 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10997332-1204 UT Primary

Addresses

Primary practice location

74 E Kimballs LN Ste 300
Draper, UT 84020-5009

Mailing address

PO Box 198560
Atlanta, GA 30384-8560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190322000667 UT Practitioner - Family Practice 1759621089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mountainstar Medical Group-St. Marks Hospital LLCGroup PAC ID 1557443322, 13 clinicians

Practice addresses (Care Compare)

74 E Kimballs LN
Suite 300
Draper, UT 84020-5009
Phone (801) 572-0311

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mountainstar Medical Group-St. Marks Hospital, LLC Family Medicine CurrentSince Dec 31, 2018 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

74 E Kimballs Ln
Ste 300
Draper, UT 84020
Phone (801) 572-0311

8846 S Redwood Rd
Ste E12
West Jordan, UT 84088
Phone (801) 266-2777

Networks

  • UT PPO D-SNP
  • UT PPO

Interoperability endpoints

  • Direct secure messaging: daniel.young@hca3.eclinicaldirectplus.com

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.

Hospital & facility affiliations 5

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": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1114301710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198560",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 E KIMBALLS LN STE 300",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205009",
            "telephone_number": "801-572-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "DANIEL",
        "middle_name": "TREVOR",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-13",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "10997332-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

Verify at the official NPI Registry.