Individual provider Active NPI

Jaime Young, NP

  • Adult Health Nurse Practitioner
  • Oakland, CA
National Provider Identifier
1780157651
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
95010794 Issued in CA
Practice address
400 29TH St Ste 501
Oakland, CA 94609-3550
Phone
(510) 268-1800
NPI assigned
Jan 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 95010794 CA Primary

Addresses

Primary practice location

400 29TH St Ste 501
Oakland, CA 94609-3550

Mailing address

400 29TH St Ste 501
Oakland, CA 94609-3550
Phone (510) 268-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20211104000445 CA Practitioner - Nurse Practitioner 2769870120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Bay Area Quality Health CorporationGroup PAC ID 8527355643, 2 clinicians

Practice addresses (Care Compare)

400 29TH St
Suite 501
Oakland, CA 94609-3550
Phone (707) 343-1412

Hospital & facility affiliations

  • Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043
  • Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95010794CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Bay Area Quality Health Corporation CurrentSince Jul 5, 2021 Accepting new patients

Locations

400 29th St
Ste 501
Oakland, CA 94609
Phone (415) 990-8111

Interoperability endpoints

  • Direct secure messaging: jyoung99306@firsthealth.direct-ci.net

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 2

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": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1780157651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 29TH ST STE 501",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093550",
            "telephone_number": "510-268-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 29TH ST STE 501",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093550",
            "telephone_number": "510-268-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JAIME",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-03",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95010794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.