Eric K Young, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME40258 Issued in FL

Practice address

1651 SE Tiffany Ave
Port St Lucie, FL 34952-7564

Phone

(772) 398-1800

Fax

(772) 398-1815

NPI assigned

Aug 4, 2006

Last updated

Oct 13, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1649288895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349950417",
            "telephone_number": "772-223-5665",
            "fax_number": "772-223-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 SE TIFFANY AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527564",
            "telephone_number": "772-398-1800",
            "fax_number": "772-398-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ERIC",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME40258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067073100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eyoung4593@direct.martinhealth.org",
            "affiliation": "N",
            "address_1": "1651 SE Tiffany Ave",
            "city": "Port St Lucie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349527564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Medina Saida Yasin, RN
• Manhal Yazji, D.D.S.
• Michael F Ybern
• Heather Yeckes-Rodin, M.D.
• Jessica Yoder
• Brion Youngs, PT, DPT
• Your Personalized Care Services, LLC
• Yuping Yuan
• Cindy Yuen, D.O.
• Omer Yusuf, M.D.

• Family Medicine Physician in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.