Mentrel Stanley Young, DSC.,C.N.S.,C.D.-N.

Primary specialty

NutritionistTaxonomy code 133N00000X

License

000870 Issued in CT

Practice address

79 Hawthorne St
Bridgeport, CT 06610-1606

Phone

(203) 400-1990

NPI assigned

Nov 24, 2008

Sex

Male

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 CT

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cornell Scott Hill Health CorporationGroup PAC ID 3072418359, 261 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

Practice roles

Locations

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.

• Cornell Scott Hill Health Corporation

  • Federally Qualified Health Center (FQHC)
  • New Haven, CT
  • NPI 1902921380
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296432000000",
    "number": "1447405915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 HAWTHORNE ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066101606",
            "telephone_number": "203-400-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 HAWTHORNE ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066101606",
            "telephone_number": "203-400-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MENTREL",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "DSC.,C.N.S.,C.D.-N.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-24",
        "last_updated": "2011-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "CT",
            "license": "000870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda L Young, LPC
• Amy J Young, PA-C
• Jacqueline Ann Young, CNM
• Joshua Young
• Kelvin Young, MD
• Michael Young
• Michelle Young, LPN
• Omera Young
• Sheikh M. Yousuf-Ali, MD
• Anne Kristin A. Ysais

• Nutritionist in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Nutritionist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2011; 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.