Organization Active NPI

Steven R. Young, Ocularist, Inc.

  • Prosthetic/Orthotic Supplier
  • Oakland, CA
National Provider Identifier
1346423639
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
STEVEN R. YOUNG, OCULARIST, INC.
Practice address
411 30TH St
Suite 512
Oakland, CA 94609-3301
Phone
(510) 836-2123
Fax
(510) 836-0383
NPI assigned
Dec 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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

Authorized official

Name
Steven R. Young, B.C.O.NPI 1154498723
Title
Ocularist/Owner
Phone
(510) 836-2123

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

411 30TH St
Suite 512
Oakland, CA 94609-3301

Mailing address

411 30TH St
Suite 512
Oakland, CA 94609-3301
Phone (510) 836-2123

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ76594ZMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930000467 CA DME Supplier - Prosthetic PersonnelDME Supplier - Ocularist 8022135144 Practice locations: Oakland, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Steven R Young Ocularist Inc411 30TH St, Oakland, CA 94609-3303(510) 836-2123 Facial Prostheses|Ocular Prostheses Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

411 30th St
Ste 512
Oakland, CA 94609
Phone (510) 836-2123

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1346423639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 30TH ST",
            "address_2": "SUITE 512",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093301",
            "telephone_number": "510-836-2123",
            "fax_number": "510-836-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 30TH ST",
            "address_2": "SUITE 512",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093301",
            "telephone_number": "510-836-2123",
            "fax_number": "510-836-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN R. YOUNG, OCULARIST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-10",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OCULARIST/OWNER",
        "authorized_official_telephone_number": "510-836-2123",
        "authorized_official_credential": "B.C.O."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ76594Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.