Organization Active NPI

Paul R. Young MD PLLC

  • Otolaryngology Physician
  • Amherst, NY
National Provider Identifier
1245675669
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
268372-1 Issued in NY
Legal business name
PAUL R. YOUNG MD PLLC
Practice address
4955 N Bailey Ave
Suite 202
Amherst, NY 14226-1206
Phone
(716) 242-8240
Fax
(716) 674-6070
NPI assigned
Apr 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2016

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

Authorized official

Name
Dr. Paul Raymond Young, MDNPI 1184858458
Title
Owner
Phone
(716) 242-8240

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 268372-1 NY Primary

Addresses

Primary practice location

4955 N Bailey Ave
Suite 202
Amherst, NY 14226-1206

Mailing address

4955 N Bailey Ave
Suite 202
Amherst, NY 14226-1206
Phone (716) 242-8240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131206000568 NY Part B Supplier - Clinic/Group Practice 6709013378 Receives reassigned benefits from 4 practitioners
Practice locations: Amherst, NY

National Provider Directory

National Provider Directory

Locations

4955 N Bailey Ave
Ste 202
Buffalo, NY 14226
Phone (716) 832-8500

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480982400000",
    "number": "1245675669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 N BAILEY AVE",
            "address_2": "SUITE 202",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261206",
            "telephone_number": "716-242-8240",
            "fax_number": "716-674-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 N BAILEY AVE",
            "address_2": "SUITE 202",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261206",
            "telephone_number": "716-242-8240",
            "fax_number": "716-674-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL R. YOUNG MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-30",
        "last_updated": "2016-12-06",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-242-8240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "268372-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.