Caleb Anthony Youngblood, MMS, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601006038 Issued in MI

Practice address

1964 W 11 Mile Rd
Berkley, MI 48072-3046

Phone

(248) 544-9300

NPI assigned

Jun 18, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Healthcare Professionals PCGroup PAC ID 0345413258, 525 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Michigan Healthcare Professionals PC

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1295023547
  Medicare reassignment Care Compare group NPD
• Michigan Healthcare Professionals PC

  • Durable Medical Equipment & Medical Supplies
  • Lapeer, MI
  • NPI 1992693303
  NPD

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424736000000",
    "number": "1235366014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1964 W 11 MILE RD",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480723046",
            "telephone_number": "248-544-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1964 W 11 MILE RD",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480723046",
            "telephone_number": "248-544-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "CALEB",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "MMS, PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-18",
        "last_updated": "2015-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601006038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Lynn Wucetich, LMSW, ACSW
• Silvana Xhajaj, FNP, BC
• Dennis Yager, SWT, CAC1
• Raegan Yerington
• Noor Yono, PHARMD
• Khalid Zafar, MD
• Suanne Zager, LMSW
• Sami Zarouk, M.D.
• Kathryn M Ziegler, MD
• Rachel Lauren Ziel, NURSE PRACTITIONER

• Medical Physician Assistant in Berkley, MI
• Providers in Berkley, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; 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.