Individual provider Active NPI

Kathleen Marie Youngs, RPAC

  • Surgical Physician Assistant
  • San Diego, CA
National Provider Identifier
1225101082
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
21492 Issued in CA
Practice address
7910 Frost St
Suite 100
San Diego, CA 92123-2771
Phone
(858) 634-5900
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 010814-1 NY
Surgical Physician Assistant 363AS0400X 21492 CA Primary

Addresses

Primary practice location

7910 Frost St
Suite 100
San Diego, CA 92123-2771

Mailing address

7910 Frost St
Suite 100
San Diego, CA 92123-2771
Phone (858) 634-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20111025000134 CA Practitioner - Physician Assistant 9436216132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Diego Diagnostic Radiology Medical Group IncGroup PAC ID 0143134353, 47 clinicians

Practice addresses (Care Compare)

751 Med Ctr CT
Chula Vista, CA 91911-6617
Phone (619) 482-3639

7910 Frost St
Suite 100
San Diego, CA 92123-2776
Phone (858) 634-5900

Hospital & facility affiliations

  • Sharp Chula Vista Medical Center Hospital, Chula Vista, CA, CCN 050222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
21492CAMDChiropractor
010814-1NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
San Diego Diagnostic Radiology Medical Group, Inc. Current Accepting new patients
San Diego Diagonstic Radiology Medical Group, Inc. CurrentSince Oct 3, 2011 Accepting new patients
San Diego Imaging, LLC CurrentSince Feb 7, 2023 Accepting new patients
San Diego Diagnostic Radiology Medical Group, Inc. CurrentSince Oct 3, 2011 Accepting new patients

Locations

751 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 482-3639

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

250 Prospect Pl
San Diego, CA 92118
Phone (619) 522-3600

7910 Frost St
Ste 100
San Diego, CA 92123
Phone (858) 634-5900

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.

Hospital & facility affiliations 1

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321315200000",
    "number": "1225101082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7910 FROST ST",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232771",
            "telephone_number": "858-634-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 FROST ST",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232771",
            "telephone_number": "858-634-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGS",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "RPAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2011-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "010814-1",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "21492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.