Individual provider Active NPI

Timothy W Young, DPM

  • Foot & Ankle Surgery Podiatrist
  • Issaquah, WA
National Provider Identifier
1508855966
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO00000389 Issued in WA
Practice address
450 NW Gilman Blvd
Suite 303
Issaquah, WA 98027-2483
Phone
(425) 391-8666
Fax
(425) 392-6433
NPI assigned
Oct 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO00000389 WA Primary

Addresses

Primary practice location

450 NW Gilman Blvd
Suite 303
Issaquah, WA 98027-2483

Mailing address

2039 E Beaver Lake Dr SE
Sammamish, WA 98075-7920
Phone (425) 391-0208

Other identifiers 1

IdentifierTypeStateIssuer
1013598MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050317001030 WA Practitioner - Podiatry 5395790745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

450 NW Gilman Blvd
Suite 303
Issaquah, WA 98027-2483
Phone (425) 391-8666

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue11
Removal of skin lesions35
Removal of nail tissue27
Removal or shaving of skin growth38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Issaquah Foot & Ankle Specialists, P.L.L.C. Foot & Ankle Surgery CurrentSince Feb 1, 2012 Accepting new patients
Issaquah Foot & Ankle Specialists PLLC CurrentSince Feb 1, 2012 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Cascade Foot and Ankle Past Accepting new patients

Locations

450 NW Gilman Blvd
Ste 303
Issaquah, WA 98027
Phone (425) 310-2542

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418860800000",
    "number": "1508855966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2039 E BEAVER LAKE DR SE",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980757920",
            "telephone_number": "425-391-0208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 NW GILMAN BLVD",
            "address_2": "SUITE 303",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272483",
            "telephone_number": "425-391-8666",
            "fax_number": "425-392-6433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "TIMOTHY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO00000389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013598",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

Verify at the official NPI Registry.