Individual provider Active NPI

Kyra-Angel D Young, PA-C

  • Medical Physician Assistant
  • Miami, FL
National Provider Identifier
1649026311
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9118881 Issued in FL
Practice address
11645 Biscayne Blvd Ste 302-304
Miami, FL 33181-3155
Phone
(305) 538-8835
Fax
(305) 994-0054
NPI assigned
Apr 24, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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 PA9118881 FL Primary

Addresses

Primary practice location

11645 Biscayne Blvd Ste 302-304
Miami, FL 33181-3155

Mailing address

11645 Biscayne Blvd Ste 207
North Miami, FL 33181-3138
Phone (305) 538-8835

Other practice location 1

1221 71st St
Miami Beach, FL 33141-3647
Phone (305) 538-8835

Other practice location 2

710 Alton Rd
Miami Beach, FL 33139-5504
Phone (305) 538-8835

Other identifiers 1

IdentifierTypeStateIssuer
123413100MedicaidFL

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
I20240813000149 FL Practitioner - Physician Assistant 5890233654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Miami Beach Community Health Center, Inc.Group PAC ID 8123090925, 49 clinicians

Practice addresses (Care Compare)

1221 71St St
Miami, FL 33141-3647
Phone (305) 538-8835

710 Alton Rd
Miami Beach, FL 33139-5504
Phone (305) 538-8835

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Miami Beach Community Health Center Inc CurrentSince Jul 31, 2024 Accepting new patients
Miami Beach Community Health Center Inc CurrentSince Jul 31, 2024 Accepting new patients

Locations

1221 71st St
Miami Beach, FL 33141

710 Alton Rd
Miami Beach, FL 33139

11645 Biscayne Blvd
Ste 207
North Miami, FL 33181
Phone (704) 297-9229

Organizations & group practices 2

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": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1649026311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 BISCAYNE BLVD STE 207",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331813138",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 BISCAYNE BLVD STE 302-304",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331813155",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1221 71st St",
            "address_purpose": "LOCATION",
            "city": "Miami Beach",
            "state": "FL",
            "postal_code": "331413647",
            "country_code": "US",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "710 Alton Rd",
            "address_purpose": "LOCATION",
            "city": "Miami Beach",
            "state": "FL",
            "postal_code": "331395504",
            "country_code": "US",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KYRA-ANGEL",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9118881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123413100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.