Individual provider Active NPI

George Sidney Young, MS, DPT, OCS

  • Physical Therapist
  • Los Alamitos, CA
National Provider Identifier
1891782231
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT11464 Issued in CA
Practice address
5122 Katella Ave
Ste 16
Los Alamitos, CA 90720-2838
Phone
(562) 795-5295
Fax
(562) 795-5297
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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 PT11464 CA Primary

Addresses

Primary practice location

5122 Katella Ave
Ste 16
Los Alamitos, CA 90720-2838

Mailing address

5122 Katella Ave
Ste 16
Los Alamitos, CA 90720-2838
Phone (562) 795-5295

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040309001403 CA Practitioner - Physical Therapist in Private Practice 2567350655 Receives reassigned benefits from 7 practitioners
Practice locations: Los Alamitos, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5122 Katella Ave
Suite 16
Los Alamitos, CA 90720-2838
Phone (562) 795-5295

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11464CAMDAcupuncturist
PT11464CAMDPhysical Therapist

Locations

5122 Katella Ave
Ste 16
Los Alamitos, CA 90720
Phone (562) 795-5295

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1891782231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5122 KATELLA AVE",
            "address_2": "STE 16",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202838",
            "telephone_number": "562-795-5295",
            "fax_number": "562-795-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5122 KATELLA AVE",
            "address_2": "STE 16",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202838",
            "telephone_number": "562-795-5295",
            "fax_number": "562-795-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "GEORGE",
        "middle_name": "SIDNEY",
        "name_prefix": "Mr.",
        "credential": "MS, DPT, OCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT11464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; 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.