Individual provider Active NPI

Andrew Johnathan Young

  • Physical Therapist
  • Nampa, ID
National Provider Identifier
1871293340
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
337 W Iowa Ave
Nampa, ID 83686-2856
Phone
(208) 467-7889
NPI assigned
Mar 3, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

337 W Iowa Ave
Nampa, ID 83686-2856

Mailing address

400 E South Water St Apt 606
Chicago, IL 60601-4056
Phone (702) 509-0686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230629003090 ID Practitioner - Physical Therapist in Private Practice 6002275633 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabauthority LLCGroup PAC ID 1355333931, 48 clinicians

Practice addresses (Care Compare)

5520 N Eagle Rd
Suite 102
Boise, ID 83713-2703
Phone (208) 938-5255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sawtooth Physical Therapy CurrentSince Nov 13, 2023 Accepting new patients
Rehabauthority, LLC Physical Therapist CurrentSince Jun 12, 2023 Accepting new patients
CSRM LLC CurrentSince Nov 15, 2023 Accepting new patients
CSRM LLC Physical Therapist CurrentSince Nov 15, 2023 Accepting new patients
Sawtooth Physical Therapy Physical Therapist CurrentSince Nov 13, 2023 Accepting new patients

Locations

2035 Corte del Nogal
Ste 200
Carlsbad, CA 92011
Phone (760) 931-8310

7979 W Rifleman St
Ste 200
Boise, ID 83704
Phone (208) 377-3850

7979 W Rifleman St
Ste 100
Boise, ID 83704
Phone (208) 375-6133

1109 S Broadway Ave
Ste 120
Boise, ID 83706
Phone (208) 473-4410

5520 N Eagle Rd
Ste 102
Boise, ID 83713
Phone (208) 938-5255

120 E Pine St
Caldwell, ID 83605
Phone (208) 454-5142

720 S Woodruff Ave
Idaho Falls, ID 83401
Phone (208) 322-8709

3015 E Magic View Dr
Ste 100
Meridian, ID 83642
Phone (208) 887-3498

337 W Iowa Ave
Nampa, ID 83686
Phone (208) 305-6838

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.

NPI Registry JSON

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1871293340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E SOUTH WATER ST APT 606",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606014056",
            "telephone_number": "702-509-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 W IOWA AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836862856",
            "telephone_number": "208-467-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ANDREW",
        "middle_name": "JOHNATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-03",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.