Individual provider Active NPI

Brian Lawrence Young, M.D.

  • Pediatrics Physician
  • Surprise, AZ
National Provider Identifier
1518995737
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
33964 Issued in AZ
Practice address
15653 N Reems Rd
Suite 110
Surprise, AZ 85374-9541
Phone
(623) 214-3454
Fax
(623) 214-3455
NPI assigned
Jun 28, 2006
Last updated
Apr 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 33964 AZ Primary

Addresses

Primary practice location

15653 N Reems Rd
Suite 110
Surprise, AZ 85374-9541

Mailing address

13954 W Waddell Rd Ste 103
Surprise, AZ 85379-8751
Phone (623) 214-3454

Other identifiers 1

IdentifierTypeStateIssuer
954679OtherAZAHCCCS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33964AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Young Arizona Pediatrics LLC Pediatrics PastSince Nov 5, 2010 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1518995737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13954 W WADDELL RD STE 103",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853798751",
            "telephone_number": "623-214-3454",
            "fax_number": "623-214-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15653 N REEMS RD",
            "address_2": "SUITE 110",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853749541",
            "telephone_number": "623-214-3454",
            "fax_number": "623-214-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "BRIAN",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "33964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "954679",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.