Individual provider Active NPI

Rei Jackson Young, D.O.

  • Family Medicine Physician
  • Roseville, CA
National Provider Identifier
1639381882
Registry record updated Sep 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A9951 Issued in CA
Practice address
2 Medical Plaza Dr
Suite 130
Roseville, CA 95661-3043
Phone
(916) 865-1400
NPI assigned
May 3, 2007
Last updated
Sep 8, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A9951 CA
Family Medicine Physician 207Q00000X 20A9951 CA Primary

Addresses

Primary practice location

2 Medical Plaza Dr
Suite 130
Roseville, CA 95661-3043

Mailing address

10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

Other identifiers 1

IdentifierTypeStateIssuer
1639381882MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080109000784 CA Practitioner - Emergency Medicine 5496835985 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2575 E Bidwell St
Suite 100
Folsom, CA 95630-6445
Phone (916) 817-3710

2800 L St
Sacramento, CA 95816-5616

4011 Woodcreek Oaks Blvd
Roseville, CA 95747-6834
Phone (530) 649-3338

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A9951CAMDFamily Medicine Physician
9951CAMDRespiratory/Developmental/Rehabilitative Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Sutter Valley Medical Foundation Family Medicine CurrentSince Sep 8, 2015 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jan 1, 2015 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jan 1, 2015 Accepting new patients
Sutter Valley Medical Foundation Family Medicine Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Sep 8, 2015 Accepting new patients
Sutter Gould Medical Foundation Family Medicine Past Accepting new patients

Locations

11795 Education St
Ste 110
Auburn, CA 95602
Phone (530) 886-6820

2020 Sutter Pl
Ste 101
Davis, CA 95616
Phone (530) 750-5830

8170 Laguna Blvd
Ste 113
Elk Grove, CA 95758
Phone (916) 478-6561

2702 Low Ct
Fairfield, CA 94534
Phone (707) 432-2600

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

2 Medical Plaza Dr
Ste 130
Roseville, CA 95661
Phone (916) 782-7778

3 Medical Plaza Dr
Ste 140
Roseville, CA 95661
Phone (916) 781-1927

10470 Old Placerville Rd
Ste 100
Sacramento, CA 95827

1201 Alhambra Blvd
Ste 230
Sacramento, CA 95816
Phone (916) 731-7728

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: ryoung241222@hisp.ehr.sutterhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441670400000",
    "number": "1639381882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL PLAZA DR",
            "address_2": "SUITE 130",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613043",
            "telephone_number": "916-865-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "REI",
        "middle_name": "JACKSON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2015-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A9951",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A9951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639381882",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.