Individual provider Active NPI

Amanda L Young, PAC

  • Physician Assistant
  • Bangor, ME
National Provider Identifier
1609500016
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2404 Issued in ME
Practice address
360 Broadway
Bangor, ME 04401-3900
Phone
(207) 907-3650
NPI assigned
Jul 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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 PA2404 ME Primary

Addresses

Primary practice location

360 Broadway
Bangor, ME 04401-3900

Mailing address

PO Box 1599
Bangor, ME 04402-1599
Phone (207) 404-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, DC, VA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20220804001288 ME Practitioner - Physician Assistant 0547642720 Reassigns benefits to 1 organization
I20251103003552 DC Practitioner - Physician Assistant 0547642720 Reassigns benefits to 1 organization
I20251125003724 VA Practitioner - Physician Assistant 0547642720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5080 Spectrum Dr
Suite 1200W
Addison, TX 75001-6443

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.58 of 100Reported as apm
Quality
83.17
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2404MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care PA Current Accepting new patients
American Current Care PA CurrentSince Oct 22, 2025 Accepting new patients
American Current Care PA CurrentSince Oct 22, 2025 Accepting new patients
American Current Care P.a. CurrentSince Oct 22, 2025 Accepting new patients
Penobscot Community Health Center Past Accepting new patients

Locations

4451 Parliament Pl
Ste G
Lanham, MD 20706
Phone (301) 459-9113

4301 W Broad St
Richmond, VA 23230
Phone (804) 358-0361

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 and National Provider Directory roles.

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": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1609500016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-404-8200",
            "fax_number": "207-947-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 BROADWAY",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013900",
            "telephone_number": "207-907-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.