Individual provider Active NPI

Regan Young, DPT

  • Physical Therapist
  • Virginia Beach, VA
National Provider Identifier
1548998586
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305215266 Issued in VA
Practice address
1745 Camelot Dr Ste 100
Virginia Beach, VA 23454-2435
Phone
(724) 504-9780
NPI assigned
Aug 9, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 2305215266 VA Primary

Addresses

Primary practice location

1745 Camelot Dr Ste 100
Virginia Beach, VA 23454-2435

Mailing address

4709 Powells Point Rd
Virginia Beach, VA 23455-1357
Phone (724) 504-9780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221227002138 VA Practitioner - Physical Therapist in Private Practice 4284004797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidewater Physical Therapy LLCGroup PAC ID 6406759281, 225 clinicians

Practice addresses (Care Compare)

1745 Camelot Dr
Suite 100
Virginia Beach, VA 23454-2435
Phone (757) 961-4800

4020 Raintree Rd
Suite D
Chesapeake, VA 23321-3749
Phone (757) 484-4241

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
85.78
Promoting interoperability
99
Improvement activities
40
Cost
75.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Aug 22, 2022 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Aug 22, 2022 Accepting new patients

Locations

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

10128 W Broad St
Bldg Iii
Glen Allen, VA 23060
Phone (804) 217-9210

12494 Warwick Blvd
Newport News, VA 23606
Phone (804) 217-9210

1745 Camelot Dr
Ste 100
Virginia Beach, VA 23454
Phone (757) 496-2300

Organizations & group practices 2

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": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1548998586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 POWELLS POINT RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234551357",
            "telephone_number": "724-504-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 CAMELOT DR STE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542435",
            "telephone_number": "724-504-9780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "REGAN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-09",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305215266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.