Individual provider Active NPI

Joel Yves Young, APRN

  • Gerontology Nurse Practitioner
  • Mansfield, TX
National Provider Identifier
1790522704
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1164153 Issued in TX
Practice address
1507 Parkside Dr
Mansfield, TX 76063-8632
Phone
(817) 983-4155
NPI assigned
Jul 9, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LG0600X 1164153 TX Primary

Addresses

Primary practice location

1507 Parkside Dr
Mansfield, TX 76063-8632

Mailing address

1507 Parkside Dr
Mansfield, TX 76063-8632
Phone (817) 983-4155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240815003138 TX Practitioner - Nurse Practitioner 5890233241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Cardio and Renal Therapeutics of North Texas PLLCGroup PAC ID 7810329638, 32 clinicians

Practice addresses (Care Compare)

5830 Collin McKinney Pkwy
Suite 302
McKinney, TX 75070-5109
Phone (214) 272-2774

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cardio & Renal Therapeutics of North Texas PLLC Single Specialty CurrentSince Jun 1, 2024 Accepting new patients

Locations

5830 Collin McKinney Pkwy
Ste 302
McKinney, TX 75070
Phone (212) 272-2774

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.

NPI Registry JSON

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1790522704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 PARKSIDE DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638632",
            "telephone_number": "817-983-4155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 PARKSIDE DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638632",
            "telephone_number": "817-983-4155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JOEL",
        "middle_name": "YVES",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1164153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.