Individual provider Active NPI

Roger Young, MD

  • Internal Medicine Physician
  • Davis, CA
National Provider Identifier
1952480683
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD214143 Issued in OR
Practice address
3325 Grosbeak CT
Davis, CA 95616-7511
Phone
(916) 704-8770
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD2020-0253 NM
Hospitalist Physician 208M00000X 13658C WY
Hospitalist Physician 208M00000X G61175 CA
Internal Medicine Physician 207R00000X MD214143 OR Primary

Addresses

Primary practice location

3325 Grosbeak CT
Davis, CA 95616-7511

Mailing address

3325 Grosbeak CT
Davis, CA 95616-7511
Phone (916) 704-8770

Other identifiers 1

IdentifierTypeStateIssuer
00G611750MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM, WY, VT, IL, OR, ME7 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 7

Enrollment IDStateProvider typePAC IDDetails
I20200417000379 TX Practitioner - Internal MedicinePractitioner - Hospitalist 7911187679 Reassigns benefits to 2 organizations
I20200528000202 NM Practitioner - Internal Medicine 7911187679 Reassigns benefits to 3 organizations
I20210812001589 WY Practitioner - Internal MedicinePractitioner - Hospitalist 7911187679 Reassigns benefits to 1 organization
I20210930000039 VT Practitioner - Internal Medicine 7911187679 Reassigns benefits to 1 organization
I20220927000334 IL Practitioner - Internal MedicinePractitioner - Hospitalist 7911187679 Reassigns benefits to 1 organization
I20230209002498 OR Practitioner - Internal Medicine 7911187679 Reassigns benefits to 2 organizations
I20230516002099 ME Practitioner - Internal Medicine 7911187679 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Center IncGroup PAC ID 5496714313, 105 clinicians

Practice addresses (Care Compare)

133 Fairfield St
Saint Albans, VT 05478-1726
Phone (802) 524-8852

167 N Main St
Tuba City Indian Medical Center
Tuba City, AZ 86045-0600
Phone (928) 283-2094

516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone (505) 722-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.18 of 100Reported as group
Quality
61.12
Improvement activities
40
Cost
81.87

Merit-based Incentive Payment System (MIPS)

Final score
77.59 of 100Reported as group
Quality
47.51
Promoting interoperability
69
Improvement activities
40
Cost
86.96

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2020-0253NMMDInternal Medicine Physician
MD214143ORMDInternal Medicine Physician
G61175CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC Internal Medicine CurrentSince Feb 2, 2023 Accepting new patients
Hospital Medicine Services of Maine LLC Hospitalist CurrentSince Jun 1, 2023 Accepting new patients
Memorial Hospital of Sweetwater County CurrentSince Aug 11, 2021 Accepting new patients
Northwestern Medical Center Inc CurrentSince Sep 30, 2023 Accepting new patients
Northwestern Medical Center, Inc CurrentSince Sep 30, 2023 Accepting new patients
Silverton Health CurrentSince Feb 2, 2023 Accepting new patients
Northwestern Medical Center, Inc. Current Accepting new patients
Hospitalist Medicine Physicians of New Mexico-TCG LLC Internal Medicine CurrentSince May 1, 2020 Accepting new patients
Hospitalist Medicine Physicians of Vermont-TCG, LLC Internal Medicine CurrentSince Aug 26, 2021 Accepting new patients
24 On Physicians, PC Hospitalist CurrentSince Jun 1, 2022 Accepting new patients
Silverton Health CurrentSince Feb 2, 2023 Accepting new patients
Unm Medical Group Inc CurrentSince Oct 24, 2022 Accepting new patients
24 On Physicians, P.C. Hospitalist CurrentSince Jun 1, 2022 Accepting new patients
Unm Medical Group, Inc. CurrentSince Oct 24, 2022 Accepting new patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Jul 17, 2023 Accepting new patients
Tuba City Regional Health Care Corporation Internal Medicine CurrentSince Apr 6, 2020 Accepting new patients
Northwestern Medical Center, Inc. Current Accepting new patients
Silverton Health Current Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince May 1, 2020 Accepting new patients
Tuba City Regional Health Care Corporation CurrentSince Apr 6, 2020 Accepting new patients
Maine Medical Services LLC Internal Medicine CurrentSince Jun 1, 2023 Accepting new patients
Legacy Clinics LLC CurrentSince Feb 2, 2023 Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

13000 Deerfield Pkwy
Ste 100
Alpharetta, GA 30004

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

57 Water St
Blue Hill, ME 04614
Phone (207) 374-3400

50 Union St
Ellsworth, ME 04605
Phone (207) 664-5304

447 N Main St
Pittsfield, ME 04967
Phone (207) 487-0981

933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476

2100 N Mlk Blvd
Clovis, NM 88101
Phone (505) 769-2141

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

347 Fairview St
Silverton, OR 97381
Phone (503) 873-5667

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

3 Crest Rd
Saint Albans, VT 05478
Phone (802) 524-4554

133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227

1200 College Dr
Rock Springs, WY 82901
Phone (307) 352-8352

Organizations & group practices 22

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.

View all 22

Hospital & facility affiliations 2

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1952480683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 GROSBEAK CT",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956167511",
            "telephone_number": "916-704-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 GROSBEAK CT",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956167511",
            "telephone_number": "916-704-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ROGER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2020-0253",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WY",
            "license": "13658C",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "G61175",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD214143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G611750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

Verify at the official NPI Registry.