Individual provider Active NPI

Leslie Elizabeth Gibson Young, FNP-BC, RN

  • Family Nurse Practitioner
  • Marblehead, MA
National Provider Identifier
1194061317
Registry record updated Aug 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2270753 Issued in MA
Practice address
1 Widger Rd
Marblehead, MA 01945-2146
Phone
(781) 631-5126
NPI assigned
Dec 15, 2012
Last updated
Aug 5, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2270753 MA Primary

Addresses

Primary practice location

1 Widger Rd
Marblehead, MA 01945-2146

Mailing address

1 Widger Rd
Marblehead, MA 01945-2146
Phone (781) 631-5126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20130325000035 MA Practitioner - Nurse Practitioner 9537304480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 739-6950

1 Widger Rd
Marblehead, MA 01945-2146
Phone (781) 631-5726

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Jan 28, 2013 Accepting new patients

Locations

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

1 Widger Rd
Marblehead, MA 01945
Phone (781) 631-5126

Interoperability endpoints

  • Direct secure messaging: young.leslie.nsmc@direct.partners.masshiway.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1355529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470355200000",
    "number": "1194061317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WIDGER RD",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019452146",
            "telephone_number": "781-631-5126",
            "fax_number": "781-631-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WIDGER RD",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019452146",
            "telephone_number": "781-631-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "LESLIE",
        "middle_name": "ELIZABETH GIBSON",
        "name_prefix": "Ms.",
        "credential": "FNP-BC, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-15",
        "last_updated": "2016-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2270753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marblehead, MA

Sources for this page

Verify at the official NPI Registry.