Individual provider Active NPI

Douglas C Young, PA-C

  • Physician Assistant
  • North Conway, NH
National Provider Identifier
1588025563
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1829 Issued in NH
Practice address
3073 White Mountain Hwy
North Conway, NH 03860-7101
Phone
(603) 356-4949
NPI assigned
Mar 17, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9109370 FL
Physician Assistant 363A00000X 1829 NH Primary

Addresses

Primary practice location

3073 White Mountain Hwy
North Conway, NH 03860-7101

Mailing address

604 Oak Commons Blvd
Kissimmee, FL 34741
Phone (321) 402-5054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160531000132 FL Practitioner - Physician Assistant 9335439603
I20220317000900 NH Practitioner - Physician Assistant 9335439603

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9109370FLMDPhysician Assistant
1829NHMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: dyoung459101@direct.mmc.mainehealth.org

NPI Registry JSON

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1588025563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 OAK COMMONS BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "34741",
            "telephone_number": "321-402-5054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3073 WHITE MOUNTAIN HWY",
            "city": "NORTH CONWAY",
            "state": "NH",
            "postal_code": "038607101",
            "telephone_number": "603-356-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "DOUGLAS",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-17",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109370",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Conway, NH

Sources for this page

Verify at the official NPI Registry.