Individual provider Active NPI

Paula D Young I, M.D.

  • Internal Medicine Physician
  • Baldwin, NY
National Provider Identifier
1477508729
Registry record updated Mar 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
178888 Issued in NY
Practice address
2280 Grand Ave
Suite 307
Baldwin, NY 11510-3164
Phone
(516) 398-0029
Fax
(516) 378-1045
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 178888 NY Primary

Addresses

Primary practice location

2280 Grand Ave
Suite 307
Baldwin, NY 11510-3164

Mailing address

2280 Grand Ave
Suite 307
Baldwin, NY 11510-3164
Phone (516) 398-0029

Other identifiers 7

IdentifierTypeStateIssuer
01663161MedicaidNY
2156275OtherAETNA
10779768OtherNYCAQH
30L87OtherNYBCBS
1423639OtherUNITEDHEALTHCARE
P1959239OtherNYOXFORD
0007098316OtherAETNA LIFE INS CO

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031106000687 NY Practitioner - General Practice 7719890763 Practice locations: Baldwin, NY; Valley Stream, NY

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2280 Grand Ave
Suite 307
Baldwin, NY 11510-3138
Phone (516) 378-0880

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
178888NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Jewish Medical Center Past Accepting new patients
Roman Brushtein Medical PLLC Internal Medicine Past Accepting new patients
County of Nassau County Controller PastSince Jan 22, 2020 Accepting new patients

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268956800000",
    "number": "1477508729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 GRAND AVE",
            "address_2": "SUITE 307",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115103164",
            "telephone_number": "516-398-0029",
            "fax_number": "516-378-1045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 GRAND AVE",
            "address_2": "SUITE 307",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115103164",
            "telephone_number": "516-398-0029",
            "fax_number": "516-378-1045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "PAULA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2010-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "178888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01663161",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2156275",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10779768",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "30L87",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "1423639",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1959239",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA LIFE INS CO",
            "identifier": "0007098316",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin, NY

Sources for this page

Verify at the official NPI Registry.