Individual provider Active NPI

Bruce W Young, M.D.

  • Family Medicine Physician
  • Olathe, KS
National Provider Identifier
1487641866
Registry record updated Jan 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0423230 Issued in KS
Practice address
1803 S Ridgeview Rd
Olathe, KS 66062-2376
Phone
(913) 829-0505
Fax
(913) 338-1311
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0423230 KS Primary

Addresses

Primary practice location

1803 S Ridgeview Rd
Olathe, KS 66062-2376

Mailing address

PO Box 741331
Atlanta, GA 30374-1331
Phone (913) 469-0503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20100630000371 KS Practitioner - Family Practice 1850422114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overland Park Surgical Specialties LLCGroup PAC ID 9234318502, 86 clinicians

Practice addresses (Care Compare)

10500 Quivira Rd
Overland Park, KS 66215-2306
Phone (913) 541-5000

10600 Mastin St
Overland Park, KS 66212-5723

1803 S Ridgeview Rd
Olathe, KS 66062-2376
Phone (913) 829-0505

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0423230KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Overland Park Surgical Specialties LLC Family Medicine CurrentSince Jan 1, 2013 Accepting new patients
College Park Family Care Center PA Family Medicine Current Accepting new patients
College Park Family Care Center, P.a. Past Accepting new patients

Locations

20333 W 151st St
Olathe, KS 66061
Phone (888) 960-1393

1803 S Ridgeview Rd
Olathe, KS 66062
Phone (913) 735-4726

10600 Mastin St
Ste C
Overland Park, KS 66212
Phone (913) 469-6447

10100 W 119th St
Ste 150
Overland Park, KS 66213
Phone (913) 469-8878

11755 W 112th St
Ste 101
Overland Park, KS 66210
Phone (913) 469-0503

11725 W 112th St
Overland Park, KS 66210
Phone (913) 469-5452

10500 Quivira Rd
Ste 130
Overland Park, KS 66215
Phone (913) 956-4200

11755 W 112th St
Ste 202
Overland Park, KS 66210
Phone (913) 469-0433

10500 Quivira Rd
Shawnee Mission, KS 66215
Phone (913) 227-0565

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: bruce.young@hca2.eclinicaldirectplus.com

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357862400000",
    "number": "1487641866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741331",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741331",
            "telephone_number": "913-469-0503",
            "fax_number": "913-338-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 S RIDGEVIEW RD",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660622376",
            "telephone_number": "913-829-0505",
            "fax_number": "913-338-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "BRUCE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2013-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0423230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

Verify at the official NPI Registry.