NPIMap

Individual provider Active NPI

Cameron Hunter Youngblood, PA-C

  • Surgical Physician Assistant
  • Steamboat Springs, CO
National Provider Identifier
1255337184
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1737 Issued in CO
Practice address
705 Marketplace PLZ Ste 200
Steamboat Springs, CO 80487-1841
Phone
(970) 879-6663
Fax
(970) 871-1234
NPI assigned
Jun 24, 2005
Last updated
Nov 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1737 CO Primary

Addresses

Primary practice location

705 Marketplace PLZ Ste 200
Steamboat Springs, CO 80487-1841

Mailing address

705 Marketplace PLZ Ste 200
Steamboat Springs, CO 80487-1841
Phone (970) 879-6663

Other identifiers 2

IdentifierTypeStateIssuer
34554378MedicaidCO
32800061MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050121000683 CO Practitioner - Physician Assistant 1052360518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley View Hospital AssociationGroup PAC ID 1850294778, 205 clinicians

Practice addresses (Care Compare)

1450 E Valley Rd
Unit 202
Basalt, CO 81621-8352
Phone (970) 384-6940

1906 Blake Ave
Glenwood SPGS, CO 81601-4227
Phone (970) 945-6533

1906 Blake Ave
Glenwood SPGS, CO 81601-4259

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1737COMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley View Hospital Association CurrentSince Oct 27, 2022 Accepting new patients
Valley View Hospital Association CurrentSince Oct 27, 2022 Accepting new patients
Valley View Hospital Association Family Medicine Past Accepting new patients

Locations

1906 Blake Ave
Glenwood Springs, CO 81601
Phone (970) 384-7033

Interoperability endpoints

  • Direct secure messaging: cameron.youngblood.1@9028.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1255337184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 MARKETPLACE PLZ STE 200",
            "city": "STEAMBOAT SPRINGS",
            "state": "CO",
            "postal_code": "804871841",
            "telephone_number": "970-879-6663",
            "fax_number": "970-871-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 MARKETPLACE PLZ STE 200",
            "city": "STEAMBOAT SPRINGS",
            "state": "CO",
            "postal_code": "804871841",
            "telephone_number": "970-879-6663",
            "fax_number": "970-871-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "CAMERON",
        "middle_name": "HUNTER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "1737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34554378",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32800061",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Steamboat Springs, CO

Sources for this page

Verify at the official NPI Registry.