Active NPI
Blair Young Clark, D.O.
- Ophthalmology Physician
- Tiffin, OH
National Provider Identifier
1205199528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 34.012724
- Practice address
- 60 Ashwood Dr
Tiffin, OH 44883-1908 - Phone
- (419) 448-8811
- Fax
- (419) 448-7418
- NPI assigned
- Jun 21, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 34.012724 | OH | Primary |
Addresses
Primary practice location
60 Ashwood Dr
Tiffin, OH 44883-1908
Mailing address
60 Ashwood Dr
Tiffin, OH 44883-1908
Phone (419) 448-8811
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0218698 | Medicaid | OH |
Other names 1
- Ms. Blair Katherine Young
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | blairyoungdo@direct-address.net | Health Information Exchange (HIE) | Wade E Young MD Inc |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170518002135 | OH | Practitioner - Ophthalmology | 2769759901 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34.012724 | OH | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wade E Young MD Inc | Ophthalmology | Current | Accepting new patients |
Locations
60 Ashwood Dr
Tiffin, OH 44883
Phone (419) 448-8811
Interoperability endpoints
- blairclarkdo@direct-address.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 and National Provider Directory roles.
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- West Virginia School of Osteopathic Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wade E Young MD Inc
Practice addresses (Care Compare)
60 Ashwood Dr
Tiffin, OH 44883-1908
Phone (419) 448-8811
Hospital & facility affiliations
- Mercy Health - Tiffin Hospital
- Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.56 of 100
- Quality
- 100
- Improvement activities
- 40
- Cost
- 75.21
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 165 |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617667200000",
"number": "1205199528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 ASHWOOD DR",
"city": "TIFFIN",
"state": "OH",
"postal_code": "448831908",
"telephone_number": "419-448-8811",
"fax_number": "419-448-7418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 ASHWOOD DR",
"city": "TIFFIN",
"state": "OH",
"postal_code": "448831908",
"telephone_number": "419-448-8811",
"fax_number": "419-448-7418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "BLAIR",
"middle_name": "YOUNG",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-21",
"last_updated": "2021-04-06",
"certification_date": "2021-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "OH",
"license": "34.012724",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0218698",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "blairyoungdo@direct-address.net",
"affiliation": "Y",
"endpointDescription": "Direct Send Messaging Address",
"affiliationName": "Wade E Young MD Inc",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "60 Ashwood Dr",
"city": "Tiffin",
"state": "OH",
"country_code": "US",
"postal_code": "448831908",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "BLAIR",
"last_name": "YOUNG",
"middle_name": "KATHERINE",
"prefix": "MS.",
"credential": "DO",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Tiffin, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.