Jeffrey Paul Young, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

K5033 Issued in TX

Practice address

2011 Moores LN
Texarkana, TX 75503-1841

Phone

(903) 792-2777

Fax

(903) 794-6728

NPI assigned

Jul 7, 2005

Last updated

Jun 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Dermatology

Education

University of Arkansas College of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Epiphany Dermatology PAGroup PAC ID 3971827791, 106 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

69.24 of 100Reported as individual

Quality

60.98

Promoting interoperability

69

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AEGICD
• Direct secure messaging: jeff.young@epiphanyderm.emadirect.md

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.

• Epiphany Dermatology PA

  • Dermatology Physician
  • Waco, TX
  • NPI 1043615263

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Dermatology Associates LLP

  • Dermatology Physician
  • Texarkana, TX
  • NPI 1245690726

  Single Specialty

  Medicare reassignment NPD
• Jeff P Young MD PA

  • Dermatology Physician
  • Texarkana, TX
  • NPI 1184959082
  Medicare reassignment
• George Edward Freeman, D.O.,P.C.

  • Internal Medicine Physician
  • Idabel, OK
  • NPI 1124194568

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1215934062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031841",
            "telephone_number": "903-792-2777",
            "fax_number": "903-794-6728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031841",
            "telephone_number": "903-792-2777",
            "fax_number": "903-794-6728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JEFFREY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AR",
            "license": "E2607",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "20679",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "K5033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "070012558",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031075701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134647001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristine Johansson Yells, PH.D., LCSW
• Jae H Yoon, D.D.S.
• Andrea Lee York, MD
• Jason Alan Yost, M.D.
• Young Health & Wellness Clinic PA (United Health & Wellness Clinic PA)
• Joseph Allen Young, DC
• Matthew Young, MD
• Paige Danielle Young
• Thomas C Young, M.D.
• Barbara Yowell, CPNP

• Dermatology Physician in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.

Verify at the official NPI Registry.