Individual provider Active NPI

Guy Mathew Young, O.D.

  • Optometrist
  • Coral Gables, FL
National Provider Identifier
1245379221
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3765 Issued in FL
Practice address
6250 Dolphin Dr
Coral Gables, FL 33158-1845
Phone
(305) 494-9321
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3765 FL Primary

Addresses

Primary practice location

6250 Dolphin Dr
Coral Gables, FL 33158-1845

Mailing address

6250 Dolphin Dr
Coral Gables, FL 33158-1845
Phone (305) 494-9321

Other practice location 1

10676 N.W. 19 st
Doral, FL 33172
Phone (305) 403-3937

Other identifiers 1

IdentifierTypeStateIssuer
620775800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031215000560 FL Practitioner - Optometry 5193622504 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC3765FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Arts Network Inc Optometrist CurrentSince Jan 7, 2024 Accepting new patients
Medical Arts Inc. Optometrist CurrentSince Nov 15, 2012 Accepting new patients
James D Hagen OD PA Optometrist PastSince Jul 27, 2024 Accepting new patients
Young Eye Associates OD PA Optometrist PastSince Jan 1, 2005 Accepting new patients

Locations

909 N Krome Ave
#M
Homestead, FL 33030
Phone (305) 494-9321

909 N Krome Ave
Homestead, FL 33030
Phone (305) 248-5004

Organizations & group practices 4

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1245379221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6250 DOLPHIN DR",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331581845",
            "telephone_number": "305-494-9321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6250 DOLPHIN DR",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331581845",
            "telephone_number": "305-494-9321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10676 N.W. 19 st",
            "address_purpose": "LOCATION",
            "city": "Doral",
            "state": "FL",
            "postal_code": "33172",
            "country_code": "US",
            "telephone_number": "305-403-3937",
            "fax_number": "305-403-6967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "GUY",
        "middle_name": "MATHEW",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620775800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.