Andrea Nichelle Young, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A12045 Issued in CA

Practice address

2683 Pacific Ave
Long Beach, CA 90806-2610

Phone

(562) 997-2350

NPI assigned

Nov 10, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 2, 2020 through Feb 2, 2028

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: andrea.young@58261044854788.direct.elationemr.com

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.

• Andrea Nichelle Young

  • Family Medicine Physician
  • Sausalito, CA
  • NPI 1518490978
  NPD (past) Authorized official
• Andrea Young DO, Inc

  • Family Medicine Physician
  • Sausalito, CA
  • NPI 1710419098
  NPD (past) Authorized official

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1699052175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2683 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2683 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062610",
            "telephone_number": "562-997-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ANDREA",
        "middle_name": "NICHELLE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-10",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A12045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theodore Youn, D.O.
• David Younan, DDS
• Young Men'S Christian Association of Greater Long Beach
• Serena Young-Nguyen, M.D.
• Allison Mei Young, LCSW
• Cynthia Marielos Young
• Daniel Jone Young, DMD
• Falon Michelle Young
• John K Young, D.O.
• Jordan Young

• Family Medicine Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.