Andrea Leigh Young, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601006782 Issued in MI

Practice address

1 Hurley PLZ
Flint, MI 48503-5902

Phone

(810) 262-9355

Fax

(810) 262-6341

NPI assigned

Sep 19, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Andrea Leigh Wilson Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Iha Olma Specialty Services LLC

  dba THIMG Obstetrics & Gynecology Bloomfield Hills

  • Obstetrics & Gynecology Physician
  • Bloomfield Township, MI
  • NPI 1457949588
  Medicare reassignment
• Iha Olma Specialty Services LLC

  dba Trinity Health IHA Medical Group Neurosurgery

  • Neurological Surgery Physician
  • Pontiac, MI
  • NPI 1033899174
  NPD
• Iha Olma Specialty Services LLC

  • Surgery Physician
  • Pontiac, MI
  • NPI 1861143976
  NPD

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1619303815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE HURLEY PLAZA",
            "address_2": "SON 5TH FLOOR",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035993",
            "telephone_number": "810-262-9355",
            "fax_number": "810-262-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902",
            "telephone_number": "810-262-9355",
            "fax_number": "810-262-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ANDREA",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "WILSON",
            "middle_name": "LEIGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shawn A York, DDS
• Amy Yorke, PT, PHD, NCS
• You Overcoming Lactation Obstacles
• Young Life Wellness
• Dominique Young-Fomby
• Carol Young, LMSW
• Edward Young
• Katelyn Young
• Kayley Marie Young, PTA
• Kimberly Beth Young, BA, RAC

• Physician Assistant in Flint, MI
• Providers in Flint, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.