Individual provider Active NPI

Matthew Young, MD

  • Emergency Medicine Physician
  • Texarkana, TX
National Provider Identifier
1316973233
Registry record updated Jan 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
K8593 Issued in TX
Practice address
2600 Saint Michael Dr
Texarkana, TX 75503-2372
Phone
(903) 614-1000
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X K8593 TX Primary

Addresses

Primary practice location

2600 Saint Michael Dr
Texarkana, TX 75503-2372

Mailing address

8905 Sundance RDG
Texarkana, TX 75503-9583
Phone (903) 223-6933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20060928000116 TX Practitioner - Emergency Medicine 8325027147 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texarkana Emergency Physicians PLLC Emergency Medicine CurrentSince May 19, 2014 Accepting new patients
Texarkana Emergency Medicine Physicians,PA Emergency Medicine PastSince Mar 1, 2004 Accepting new patients
Emergency Associates of Texas, PA Emergency Medicine PastSince Jun 22, 2006 Accepting new patients

Locations

1000 Pine St
Texarkana, TX 75501
Phone (903) 798-7365

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201219200000",
    "number": "1316973233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8905 SUNDANCE RDG",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755039583",
            "telephone_number": "903-223-6933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SAINT MICHAEL DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032372",
            "telephone_number": "903-614-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2008-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "K8593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.