Polly Jane Young, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F303481 Issued in NY

Practice address

99 East State Street
Gloversville, NY 12078

Phone

(518) 752-5275

Fax

(518) 752-5277

NPI assigned

Jun 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Polly J Peck Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Nurse Practitioner

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gloversville Physician Medicine Services PCGroup PAC ID 1850536228, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Nathan Littauer Hospital Hospital, Gloversville, NY, CCN 330276

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Gloversville Physician Medicine Services PC

  • Hospitalist Physician
  • Gloversville, NY
  • NPI 1487907630
  Medicare reassignment Care Compare group
• Atlantic Professional Services of Rhode Island Incorporated

  • Hospitalist Physician
  • Wakefield, RI
  • NPI 1922036946

  Nurse Practitioner

  NPD
• Nathan Littauer Hospital Association

  • Skilled Nursing Facility
  • Gloversville, NY
  • NPI 1073541850
  NPD (past)
• Nathan Littauer Hospital Association

  • Rural Acute Care Hospital
  • Gloversville, NY
  • NPI 1336145168
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Nathan Littauer Hospital & Nursing Home

  • General Acute Care Hospital
  • Gloversville, NY
  • NPI 1538296207
  Care Compare affiliation
• Nathan Littauer Hospital Association

  • Pharmacy
  • Gloversville, NY
  • NPI 1285706655

  Hospital

  Care Compare affiliation
• Nathan Littauer Hospital Association

  • Rural Acute Care Hospital
  • Gloversville, NY
  • NPI 1336145168
  Care Compare affiliation
• Nathan Littauer Hospital Association

  • Clinic/Center
  • Gloversville, NY
  • NPI 1770671448

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1669401022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1250",
            "address_2": "99 EAST STATE STREET",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "12078",
            "telephone_number": "518-752-5275",
            "fax_number": "518-752-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 EAST STATE STREET",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "12078",
            "telephone_number": "518-752-5275",
            "fax_number": "518-752-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "POLLY",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "303481",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F303481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02357431",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSH NE NY",
            "identifier": "000403459002",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTHPLAN",
            "identifier": "696035",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "POLLY",
            "last_name": "PECK",
            "middle_name": "J",
            "credential": "ANP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sheila Ann Wood
• Elizabeth Wright
• Lori L Young, LMHC
• Marisa Lee Young
• Meagan Young
• Tammy Sue Young
• Wendy Brady Zawilinski, RPH
• Alianna Zevola
• Gabor Zoltay, MD

• Adult Health Nurse Practitioner in Gloversville, NY
• Providers in Gloversville, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.

Verify at the official NPI Registry.