NPIMap

Individual provider Active NPI

John Youngblood, M.D.

  • Family Medicine Physician
  • Auburn, CA
National Provider Identifier
1285714782
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C51762 Issued in CA
Practice address
11670 Atwood Rd
Auburn, CA 95603-9522
Phone
(530) 887-2810
Fax
(530) 887-2849
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C51762 CA Primary

Addresses

Primary practice location

11670 Atwood Rd
Auburn, CA 95603-9522

Mailing address

11670 Atwood Rd
Auburn, CA 95603-9522
Phone (530) 887-2810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050202000465 CA Practitioner - Family Practice 6901857440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Eastern Virginia Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2261 Douglas Blvd
Roseville, CA 95661-3831
Phone (916) 783-7109

3200 Bell Rd
Auburn, CA 95603-9244
Phone (530) 886-7616

500 University Ave
Suite 220
Sacramento, CA 95825-6525
Phone (916) 734-2011

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Jan 29, 2013 Accepting new patients
Regents of the University of California CurrentSince Jan 29, 2013 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Essent PRMC LP Past Accepting new patients

Locations

3200 Bell Rd
Auburn, CA 95603
Phone (530) 886-7616

4900 Broadway
Ste 1200
Sacramento, CA 95820
Phone (916) 734-9255

500 University Ave
Ste 220
Sacramento, CA 95825
Phone (916) 286-8700

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285714782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11670 ATWOOD RD",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956039522",
            "telephone_number": "530-887-2810",
            "fax_number": "530-887-2849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11670 ATWOOD RD",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956039522",
            "telephone_number": "530-887-2810",
            "fax_number": "530-887-2849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C51762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

Verify at the official NPI Registry.