Individual provider Active NPI

Peter Ashton Young, PA-C

  • Physician Assistant
  • Elk Grove, CA
National Provider Identifier
1295207363
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
9250 Big Horn Blvd
Elk Grove, CA 95758-1298
Phone
(916) 925-7020
NPI assigned
Dec 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

9250 Big Horn Blvd
Elk Grove, CA 95758-1298

Mailing address

9250 Big Horn Blvd
Elk Grove, CA 95758-1298

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190523000485 CA Practitioner - Physician Assistant 8022351634 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56637CAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Glacier Dermatology PC Dermatology PastSince Nov 2, 2017 Accepting new patients
Highline Dermatology & Skin Cancer Dermatology PastSince Oct 1, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pyoung238251@hpmg.direct-ci.net

Organizations & group practices 3

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": "1546041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1295207363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 BIG HORN BLVD",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957581298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 BIG HORN BLVD",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957581298",
            "telephone_number": "916-925-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "PETER",
        "middle_name": "ASHTON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-29",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

Verify at the official NPI Registry.