Individual provider Active NPI

Charles Young, NP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1215445788
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP018575 Issued in PA
Practice address
861 E Allegheny Ave
Philadelphia, PA 19134-2401
Phone
(215) 831-1100
NPI assigned
Jan 17, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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 SP018575 PA Primary

Addresses

Primary practice location

861 E Allegheny Ave
Philadelphia, PA 19134-2401

Mailing address

4417 N 6TH St
Philadelphia, PA 19140-2319
Phone (215) 302-3150

Other practice location 1

4417 N 6th St
Philadelphia, PA 19140-2319
Phone (215) 302-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20180416000117 PA Practitioner - Nurse Practitioner 0749543205 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ophelia Medical Group FL PAGroup PAC ID 7810398534, 103 clinicians
Esperanza Health Center, Inc.Group PAC ID 6103815071, 32 clinicians

Practice addresses (Care Compare)

161 Cecil B Moore Ave
Apt 204
Philadelphia, PA 19122-3243
Phone (215) 585-2144

861 E Allegheny Ave
Philadelphia, PA 19134-2401
Phone (215) 302-3600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP018575PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ophelia Medical Group FL, P.a. CurrentSince Jun 2, 2025 Accepting new patients
Ophelia Medical Group, P.C. CurrentSince Jun 2, 2025 Accepting new patients
Esperanza Health Center, Inc. CurrentSince Feb 25, 2018 Accepting new patients
Esperanza Health Center, Inc. Past Accepting new patients

Locations

228 Park Ave S
New York, NY 10003
Phone (215) 588-2144

4417 N 6th St
Philadelphia, PA 19140
Phone (215) 302-3150

861 E Allegheny Ave
Philadelphia, PA 19134
Phone (215) 302-3600

Organizations & group practices 5

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": "1516147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1215445788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4417 N 6TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191402319",
            "telephone_number": "215-302-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 E ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191342401",
            "telephone_number": "215-831-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4417 N 6th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191402319",
            "country_code": "US",
            "telephone_number": "215-302-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "CHARLES",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-17",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP018575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.