Individual provider Active NPI

Tracy P Young, CRNA

  • Certified Registered Nurse Anesthetist
  • New Iberia, LA
National Provider Identifier
1629036785
Registry record updated Jun 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN085074 Issued in LA
Practice address
1100 Andre St Ste 300
Yps Anesthesia
New Iberia, LA 70563-2159
Phone
(337) 364-9225
Fax
(337) 364-6094
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN085074 LA Primary

Addresses

Primary practice location

1100 Andre St Ste 300
Yps Anesthesia
New Iberia, LA 70563-2159

Mailing address

PO Box 20452
Yps-Cred
Columbus, OH 43220-0452
Phone (614) 442-2406

Other identifiers 5

IdentifierTypeStateIssuer
1111155MedicaidLA
8082UUOtherTXBCBS TX
198748905MedicaidTX
1629036785OtherLABCBS LA
198748902MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Yps Healthcare LLC PastSince Nov 12, 2014 Accepting new patients
Graham Anesthesia Services LLC Past Accepting new patients
Mid-Louisiana Anesthesia Consultants, Apmc PastSince Jul 1, 1995 Accepting new patients
Jorge J Bravo MD a Professional Corporation Past Accepting new patients
South Louisiana Anesthesiology Associates Inc Past Accepting new patients
DRS Burleigh, Dupleix and Rees Past Accepting new patients
Willis Knighton Medical Center Inc. Crna Group Nurse Anesthetist, Certified Registered Past Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371168000000",
    "number": "1629036785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20452",
            "address_2": "YPS-CRED",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432200452",
            "telephone_number": "614-442-2406",
            "fax_number": "614-442-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 ANDRE ST STE 300",
            "address_2": "YPS ANESTHESIA",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705632159",
            "telephone_number": "337-364-9225",
            "fax_number": "337-364-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "TRACY",
        "middle_name": "P",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2013-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN085074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1111155",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "8082UU",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198748905",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS LA",
            "identifier": "1629036785",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198748902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Iberia, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.