Individual provider Active NPI

Cheryl Elizabeth Young, PA C

  • Medical Physician Assistant
  • Rockledge, FL
National Provider Identifier
1639158652
Registry record updated Dec 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9102533 Issued in FL
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

Updated by the provider on Dec 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
P00369248OtherFLRR 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 PAGroup PAC ID 3678563251, 14 clinicians

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 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9102533FLMDMedical Physician Assistant

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: 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

Verify at the official NPI Registry.