Individual provider Active NPI

Zachary Tuck Young

  • Plastic Surgery Physician
  • Little Rock, AR
National Provider Identifier
1699092205
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
E-12763 Issued in AR
Practice address
9500 Kanis Rd Ste 502
Little Rock, AR 72205-6389
Phone
(501) 219-8388
NPI assigned
Apr 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X E-12763 AR Primary

Addresses

Primary practice location

9500 Kanis Rd Ste 502
Little Rock, AR 72205-6389

Mailing address

9500 Kanis Rd Ste 502
Little Rock, AR 72205-6389
Phone (501) 219-8388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20200427000806 AR Practitioner - Plastic and Reconstructive Surgery 4587982103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Arkansas College of Medicine, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Arkansas Plastic Surgery, P.a.Group PAC ID 3072683457, 2 clinicians

Practice addresses (Care Compare)

9500 Kanis Rd
Suite 502
Little Rock, AR 72205-6389
Phone (501) 219-8388

Hospital & facility affiliations

  • Baptist Health Medical Center-Little Rock Hospital, Little Rock, AR, CCN 040114

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-12763ARMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Plastic Surgery, P.a. Plastic Surgery CurrentSince Jun 13, 2020 Accepting new patients

Locations

9500 Kanis Rd
Ste 502
Little Rock, AR 72205
Phone (501) 219-8388

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1699092205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 KANIS RD STE 502",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056389",
            "telephone_number": "501-219-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 KANIS RD STE 502",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056389",
            "telephone_number": "501-219-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ZACHARY",
        "middle_name": "TUCK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-23",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "AR",
            "license": "E-12763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.