Individual provider Active NPI

Vandana K Young, PA

  • Physician Assistant
  • Litchfield Park, AZ
National Provider Identifier
1598773301
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3517 Issued in AZ
Practice address
14044 W Camelback Rd
Litchfield Park, AZ 85340-9428
Phone
(623) 935-9600
Fax
(623) 935-9602
NPI assigned
Aug 4, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3517 AZ Primary

Addresses

Primary practice location

14044 W Camelback Rd
Litchfield Park, AZ 85340-9428

Mailing address

14044 W Camelback Rd
Litchfield Park, AZ 85340-9428
Phone (623) 935-9600

Other practice location 1

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (602) 344-5651

Other practice location 2

21753 N 77th Ave
Peoria, AZ 85382-2110
Phone (623) 935-9600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20081009000259 AZ Practitioner - Physician Assistant 4082667563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pinnacle Family Medicine PLCGroup PAC ID 7012015670, 9 clinicians

Practice addresses (Care Compare)

14044 W Camelback Rd
Suite 204
Litchfield Park, AZ 85340-9426
Phone (623) 935-9600

21753 N 77TH Ave
Peoria, AZ 85382-2110
Phone (623) 935-9600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3517AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Family Medicine PLC PastSince Sep 5, 2023 Accepting new patients

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, 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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1598773301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14044 W CAMELBACK RD",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853409428",
            "telephone_number": "623-935-9600",
            "fax_number": "623-935-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14044 W CAMELBACK RD",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853409428",
            "telephone_number": "623-935-9600",
            "fax_number": "623-935-9602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 E Roosevelt St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850084973",
            "country_code": "US",
            "telephone_number": "602-344-5651",
            "fax_number": "602-344-5578",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21753 N 77th Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853822110",
            "country_code": "US",
            "telephone_number": "623-935-9600",
            "fax_number": "623-935-9602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "VANDANA",
        "middle_name": "K",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Litchfield Park, AZ

Sources for this page

Verify at the official NPI Registry.