Individual provider Active NPI

Timothy P Young, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Salem, NH
National Provider Identifier
1265454664
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD436939 Issued in PA
Practice address
70 Butler St.
Salem, NH 03079
Phone
(603) 893-2900
Fax
(603) 893-1628
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 200600824 NC
Physical Medicine & Rehabilitation Physician 208100000X MD436939 PA Primary

Addresses

Primary practice location

70 Butler St.
Salem, NH 03079

Mailing address

70 Butler St.
Salem, NH 03079
Phone (603) 893-2900

Other identifiers 5

IdentifierTypeStateIssuer
1023289300001MedicaidPA
1423KOtherNCNCBCBS
5904301MedicaidNC
N0082BMedicaidSC
0203238MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121128000196 MA Practitioner - Physical Medicine and Rehabilitation 4587661798 Reassigns benefits to 2 organizations
I20210130000183 NH Practitioner - Physical Medicine and Rehabilitation 4587661798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Tulane University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
NRHN Rehab Physician Services, IncGroup PAC ID 2466687165, 21 clinicians

Practice addresses (Care Compare)

105 Corporate Dr
Portsmouth, NH 03801-6825
Phone (603) 501-5584

70 Butler St
Salem, NH 03079-3925
Phone (603) 501-5584

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200600824NCMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Nov 1, 2012 Accepting new patients
Massachusetts General Physicians Organization Inc Physical Medicine & Rehabilitation CurrentSince Nov 1, 2012 Accepting new patients
NRHN Rehab Physician Services, Inc Physical Medicine & Rehabilitation CurrentSince Dec 14, 2020 Accepting new patients
Saint Raphael Faculty Physicians Past Accepting new patients
Gaylord Hospital, Inc. PastSince Sep 8, 2025 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

105 Corporate Dr
Portsmouth, NH 03801
Phone (603) 501-5500

70 Butler St
Salem, NH 03079
Phone (603) 893-2900

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6076/brand/1/csg/1/fhir/r4
  • Direct secure messaging: timothy.young.1@6076.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Northeast Rehabilitation Hospital NetworkSalem, NH, CCN 303026 Hospital Corporate Officer Jul 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1265454664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 BUTLER ST.",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "03079",
            "telephone_number": "603-893-2900",
            "fax_number": "603-893-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 BUTLER ST.",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "03079",
            "telephone_number": "603-893-2900",
            "fax_number": "603-893-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "TIMOTHY",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": "200600824",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD436939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023289300001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBCBS",
            "identifier": "1423K",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5904301",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N0082B",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0203238",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, NH

Sources for this page

Verify at the official NPI Registry.