Individual provider Active NPI

Regina Mary Young, ADULT HEALTH NP

  • Adult Health Nurse Practitioner
  • Oakdale, NY
National Provider Identifier
1235521477
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
30307087 Issued in NY
Practice address
305 Locust Ave
Oakdale, NY 11769-1652
Phone
(631) 218-5900
NPI assigned
Feb 25, 2015
Last updated
Feb 25, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 30307087 NY Primary

Addresses

Primary practice location

305 Locust Ave
Oakdale, NY 11769-1652

Mailing address

1123 Pacific Ave
Tacoma, WA 98402-4303
Phone (253) 682-1710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20171107002436 NY Practitioner - Nurse Practitioner 1456617430 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ilm Medical Care PLLCGroup PAC ID 2769610989, 37 clinicians

Practice addresses (Care Compare)

2975 Independence Ave
Bronx, NY 10463-4620
Phone (718) 542-1700

Merit-based Incentive Payment System (MIPS)

Final score
23.45 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
78.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30307087NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ilm Medical Care PLLC CurrentSince Jul 31, 2023 Accepting new patients
North Shore-Lij Medical PC CurrentSince Sep 11, 2017 Accepting new patients
Dinesh Sethi Physician PC CurrentSince Jan 1, 2023 Accepting new patients
Infinite Medical PC CurrentSince Apr 21, 2020 Accepting new patients
North Shore - Lij Medical PC CurrentSince Sep 11, 2017 Accepting new patients

Locations

600 E Crescent Ave
Ste 305
Upper Saddle River, NJ 07458

2975 Independence Ave
Bronx, NY 10463
Phone (718) 542-1700

250 Skillman St
Ste 202
Brooklyn, NY 11205

393 Broadway
Brooklyn, NY 11211
Phone (516) 984-9692

11915 27th Ave
Flushing, NY 11354
Phone (631) 681-4754

3617 Parsons Blvd
Flushing, NY 11354
Phone (718) 888-5200

300 Community Dr
Manhasset, NY 11030

305 Locust Ave
Oakdale, NY 11769
Phone (631) 218-5900

972 Brush Hollow Rd
Westbury, NY 11590

1521 Straight Path
Wyandanch, NY 11798
Phone (631) 643-3800

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1235521477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 PACIFIC AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024303",
            "telephone_number": "253-682-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 LOCUST AVE",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691652",
            "telephone_number": "631-218-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "REGINA",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "ADULT HEALTH NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-25",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "30307087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, NY

Sources for this page

Verify at the official NPI Registry.