Individual provider Active NPI

Keith B Young, RPA-C

  • Physician Assistant
  • Allegany, NY
National Provider Identifier
1346220274
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005206 Issued in NY
Practice address
112 W Main St
Allegany, NY 14706-1204
Phone
(716) 981-1410
NPI assigned
Jan 18, 2006
Last updated
Mar 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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 005206 NY Primary

Addresses

Primary practice location

112 W Main St
Allegany, NY 14706-1204

Mailing address

112 W Main St
Allegany, NY 14706-1204
Phone (716) 373-0700

Other identifiers 1

IdentifierTypeStateIssuer
02250255MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20041109000079 NY Practitioner - Physician Assistant 6507829751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064

921 Wayne St
Olean, NY 14760-2255
Phone (716) 379-8600

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnow Urgent Care, PC CurrentSince Aug 20, 2019 Accepting new patients

Locations

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

4752 Commercial Dr
New Hartford, NY 13413
Phone (315) 275-3046

921 Wayne St
Olean, NY 14760
Phone (716) 244-3834

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1346220274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 W MAIN ST",
            "city": "ALLEGANY",
            "state": "NY",
            "postal_code": "147061204",
            "telephone_number": "716-373-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 W MAIN ST",
            "city": "ALLEGANY",
            "state": "NY",
            "postal_code": "147061204",
            "telephone_number": "716-981-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KEITH",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02250255",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allegany, NY

Sources for this page

Verify at the official NPI Registry.