NPIMap

Individual provider Active NPI

Nathan Paul Young

  • Physician Assistant
  • Perham, MN
National Provider Identifier
1619782190
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15618 Issued in MN
Practice address
1000 Coney St W
Perham, MN 56573-2102
Phone
(218) 347-1200
NPI assigned
Feb 11, 2025
Last updated
Feb 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15618 MN Primary
Physician Assistant 363A00000X PAC1172 ND
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1000 Coney St W
Perham, MN 56573-2102

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

1612 12th Ave SE
East Grand Forks, MN 56721-3229
Phone (218) 371-9598

Other practice location 2

5225 23rd Ave S
Fargo, ND 58104-7927
Phone (701) 417-2575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250827000585 ND Practitioner - Physician Assistant 9638679228 Reassigns benefits to 1 organization
I20260206000191 MN Practitioner - Physician Assistant 9638679228 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of North Dakota School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perham Hospital DistrictGroup PAC ID 2264327766, shared by 5 NPIs, 40 clinicians

Practice addresses (Care Compare)

1000 Coney St W
Perham, MN 56573-2102
Phone (218) 347-1656

1000 Coney W St
Perham, MN 56573-2102

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15618MNMDPhysician Assistant
PAC1172NDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Jul 28, 2025 Accepting new patients
Sanford Medical Center Fargo Current Accepting new patients
Perham Hospital District CurrentSince Dec 28, 2025 Accepting new patients
Sanford Medical Center Fargo CurrentSince Jul 28, 2025 Accepting new patients
Perham Hospital District CurrentSince Dec 28, 2025 Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients

Locations

1000 Coney St W
Perham, MN 56573
Phone (218) 347-1200

5225 23rd Ave S
Fargo, ND 58104
Phone (701) 234-5933

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Organizations & group practices 8

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.

Hospital & facility affiliations 7

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": "1739232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1619782190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CONEY ST W",
            "city": "PERHAM",
            "state": "MN",
            "postal_code": "565732102",
            "telephone_number": "218-347-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1612 12th Ave SE",
            "address_purpose": "LOCATION",
            "city": "East Grand Forks",
            "state": "MN",
            "postal_code": "567213229",
            "country_code": "US",
            "telephone_number": "218-371-9598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5225 23rd Ave S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581047927",
            "country_code": "US",
            "telephone_number": "701-417-2575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "NATHAN",
        "middle_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-11",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "15618",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC1172",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perham, MN

Sources for this page

Verify at the official NPI Registry.