Amber Rachelle Young, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA21615 Issued in CA

Practice address

1125 E 17TH St
Suite W-248
Santa Ana, CA 92701-2201

Phone

(714) 547-5151

Fax

(714) 547-4027

NPI assigned

Sep 22, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kristen Forman MD IncGroup PAC ID 6204077191, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Kristen Forman MD Inc

  • Procedural Dermatology Physician
  • Newport Beach, CA
  • NPI 1073950325
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1427331776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 E 17TH ST",
            "address_2": "SUITE W-248",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012201",
            "telephone_number": "714-547-5151",
            "fax_number": "714-547-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 E 17TH ST",
            "address_2": "SUITE W-248",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012201",
            "telephone_number": "714-547-5151",
            "fax_number": "714-547-4027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "AMBER",
        "middle_name": "RACHELLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Andrea Nicole Youboty
• Jamie Youn
• Suck Y Youn, MD
• Eva Mei Young-Ross, RD
• Alexis Dupree Young, MSW
• Carissa Young, MD
• Craig Young, MFT
• De'Ondra Kellie Young
• Desiree Mishae Young
• Detrice Young

• Medical Physician Assistant in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.