Individual provider Active NPI

Breanna Alisia Young, PA-C

  • Physician Assistant
  • Arvada, CO
National Provider Identifier
1821695339
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
15389 W 91St Dr Ste 200
Arvada, CO 80007-1406
Phone
(303) 403-7933
Fax
(303) 403-7945
NPI assigned
Oct 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

15389 W 91St Dr Ste 200
Arvada, CO 80007-1406

Mailing address

15389 W 91St Dr Ste 200
Arvada, CO 80007-1406
Phone (034) 037-9333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210121002296 NV Practitioner - Physician Assistant 2668886250 Reassigns benefits to 1 organization
I20240822001729 CO Practitioner - Physician Assistant 2668886250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Intermountain Medical Group Denver LLCGroup PAC ID 0840513552, 571 clinicians

Practice addresses (Care Compare)

15389 W 91St Dr
Arvada, CO 80007-1400

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

Hospital & facility affiliations

  • Intermountain Health Lutheran Hospital Hospital, Wheat Ridge, CO, CCN 060009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
CTH Physicians Clinic Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Aug 12, 2024 Accepting new patients
Carson Tahoe Physician Clinics CurrentSince Jan 15, 2021 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Aug 12, 2024 Accepting new patients
Intermountain Medical Group Denver, LLC Past Accepting new patients

Locations

15389 W 91st Dr
Ste 200
Arvada, CO 80007
Phone (303) 403-7933

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

2874 N Carson St
Ste 200
Carson City, NV 89706
Phone (775) 283-3220

2874 N Carson St
Ste 120
Carson City, NV 89706
Phone (775) 445-5181

Organizations & group practices 5

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 5

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": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1821695339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15389 W 91ST DR STE 200",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800071406",
            "telephone_number": "034-037-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15389 W 91ST DR STE 200",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800071406",
            "telephone_number": "303-403-7933",
            "fax_number": "303-403-7945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "BREANNA",
        "middle_name": "ALISIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

Verify at the official NPI Registry.