Individual provider Active NPI

Steven R Young, BCO BOARD CERTIFIED

  • Ocularist
  • Oakland, CA
National Provider Identifier
1154498723
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OcularistTaxonomy code 156FX1700X
Practice address
411 30TH Street
Ste 512
Oakland, CA 94609-3303
Phone
(510) 836-2123
Fax
(510) 836-0383
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ocularist 156FX1700X Primary

Addresses

Primary practice location

411 30TH Street
Ste 512
Oakland, CA 94609-3303

Mailing address

411 30TH Street
Ste 512
Oakland, CA 94609-3303
Phone (510) 836-2123

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ76594ZMedicaidCA

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Steven R. Young, Ocularist, Inc. Ocularist Current Accepting new patients

Locations

411 30th St
Ste 512
Oakland, CA 94609
Phone (510) 836-2123

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.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1154498723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 30TH STREET",
            "address_2": "STE 512",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093303",
            "telephone_number": "510-836-2123",
            "fax_number": "510-836-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 30TH STREET",
            "address_2": "STE 512",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093303",
            "telephone_number": "510-836-2123",
            "fax_number": "510-836-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "STEVEN",
        "middle_name": "R",
        "credential": "BCO BOARD CERTIFIED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ocularist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ76594Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.