Active NPI
Mason L Young, OD
- Optometrist
- Corning, AR
National Provider Identifier
1952389520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2536
- Practice address
- 400 W 4TH St
Corning, AR 72422-2724 - Phone
- (870) 857-2020
- Fax
- (870) 857-2022
- NPI assigned
- Jan 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2536 | AR | Primary |
Addresses
Primary practice location
400 W 4TH St
Corning, AR 72422-2724
Mailing address
400 W 4TH St
Corning, AR 72422-2724
Phone (870) 857-2020
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 150870722 | Medicaid | AR | |
| 49866 | Other | AR | BLUE CROSS / BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031120000854 | AR | Practitioner - Optometry | 3779487871 | Practice locations: Corning, AR |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern College of Optometry, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
400 W 4TH St
Corning, AR 72422-2724
Phone (870) 857-2020
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 23 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2536 | AR | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225152000000",
"number": "1952389520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 W 4TH ST",
"city": "CORNING",
"state": "AR",
"postal_code": "724222724",
"telephone_number": "870-857-2020",
"fax_number": "870-857-2022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 W 4TH ST",
"city": "CORNING",
"state": "AR",
"postal_code": "724222724",
"telephone_number": "870-857-2020",
"fax_number": "870-857-2022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "MASON",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-04",
"last_updated": "2008-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AR",
"license": "2536",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "150870722",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS / BLUE SHIELD",
"identifier": "49866",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Corning, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.