NPIMap

Individual provider Active NPI

Todd J Youngblood, MD

  • Family Medicine Physician
  • Shenandoah, TX
National Provider Identifier
1912919473
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M1413 Issued in TX
Practice address
9201 Pinecroft Dr Ste 200
Shenandoah, TX 77380-3889
Phone
(281) 863-9554
Fax
(832) 232-5591
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M1413 TX Primary

Addresses

Primary practice location

9201 Pinecroft Dr Ste 200
Shenandoah, TX 77380-3889

Mailing address

9201 Pinecroft Dr Ste 200
Shenandoah, TX 77380-3889
Phone (812) 863-9554

Other identifiers 2

IdentifierTypeStateIssuer
186295501MedicaidTX
8R7355OtherTXBCBS OF TEXAS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060510000628 TX Practitioner - Family Practice 9830100445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Woodlands Diagnostic Clinic PAGroup PAC ID 1456762863, 5 clinicians

Practice addresses (Care Compare)

9201 Pinecroft Dr
Suite 200
Shenandoah, TX 77380-3889
Phone (281) 863-9554

Hospital & facility affiliations

  • Phoenix Healthcare Services, Inc Home health agency, Houston, TX, CCN 679498
  • Choice Health at Home Home health agency, Tomball, TX, CCN 677926
  • Accentcare Home Health of Houston - South, LLC Home health agency, Sugar Land, TX, CCN 679102
  • Tops Surgical Specialty Hospital Hospital, Houston, TX, CCN 450774
  • HCA Houston Healthcare Tomball Hospital, Tomball, TX, CCN 450670
  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184
  • Houston Methodist the Woodlands Hospital Hospital, The Woodlands, TX, CCN 670122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Woodlands Diagnostic Clinic, PA CurrentSince Sep 30, 2020 Accepting new patients
West Houston Two Medical Group, PLLC Past Accepting new patients
Southwest Texas Two Medical Group, PLLC Family Medicine Past Accepting new patients

Locations

800 Peakwood Dr
Ste 4F
Houston, TX 77090
Phone (832) 232-5673

9201 Pinecroft Dr
Ste 200
Shenandoah, TX 77380
Phone (281) 394-4704

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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 12

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1912919473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 PINECROFT DR STE 200",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773803889",
            "telephone_number": "812-863-9554",
            "fax_number": "832-232-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 PINECROFT DR STE 200",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773803889",
            "telephone_number": "281-863-9554",
            "fax_number": "832-232-5591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "TODD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M1413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186295501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "8R7355",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

Verify at the official NPI Registry.