Active NPI
Cheryl Elizabeth Young, PA C
- Medical Physician Assistant
- Rockledge, FL
National Provider Identifier
1639158652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA9102533
- Practice address
- 1286 Florida Ave S
Rockledge, FL 32955-2484 - Phone
- (321) 636-7780
- Fax
- (321) 636-1152
- NPI assigned
- Jan 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA9102533 | FL | Primary |
Addresses
Primary practice location
1286 Florida Ave S
Rockledge, FL 32955-2484
Mailing address
1286 Florida Ave S
Rockledge, FL 32955-2484
Phone (321) 636-7780
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00369248 | Other | FL | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041106000040 | FL | Practitioner - Physician Assistant | 9335102714 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- DRS Roberts and Bryan PA
Practice addresses (Care Compare)
1286 Florida Ave S
Rockledge, FL 32955-2448
1286 S Florida Ave
Rockledge, FL 32955-2479
Phone (321) 636-7780
150 N Sykes Creek Pkwy
Suite 102
Merritt Island, FL 32953-3488
Phone (321) 301-4747
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9102533 | FL | MD | Medical Physician Assistant |
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- cherylyoung@brevardskin.allscriptsdirect.net
Organizations & group practices 1
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": "1136851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386028800000",
"number": "1639158652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1286 FLORIDA AVE S",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329552484",
"telephone_number": "321-636-7780",
"fax_number": "321-636-1152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1286 FLORIDA AVE S",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329552484",
"telephone_number": "321-636-7780",
"fax_number": "321-636-1152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "CHERYL",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "PA C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-10",
"last_updated": "2013-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA9102533",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00369248",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rockledge, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.