Individual provider Active NPI

Katherine Mary Young, PA-C, MS

  • Physician Assistant
  • Centennial, CO
National Provider Identifier
1760417299
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2080 Issued in CO
Practice address
7030 S Yosemite St
Centennial, CO 80112-2026
Phone
(303) 721-9984
Fax
(303) 267-4566
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 2080 CO
Medical Physician Assistant 363AM0700X 2080 CO
Physician Assistant 363A00000X 2080 CO Primary

Addresses

Primary practice location

7030 S Yosemite St
Centennial, CO 80112-2026

Mailing address

7030 S Yosemite St
Centennial, CO 80112-2026
Phone (303) 721-9984

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20051108000372 CO Practitioner - Physician Assistant 2567480593 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clinix Health Services Past Accepting new patients
Leslie R Capin MD PC Dermatology PastSince Sep 1, 2013 Accepting new patients
Advanced Dermatology of Colorado, PC Dermatology Past Accepting new patients

Organizations & group practices 4

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1760417299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7030 S YOSEMITE ST",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801122026",
            "telephone_number": "303-721-9984",
            "fax_number": "303-267-4566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7030 S YOSEMITE ST",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801122026",
            "telephone_number": "303-721-9984",
            "fax_number": "303-267-4566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KATHERINE",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "PA-C, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "2080",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "2080",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.