Individual provider Active NPI

Rebecca Casimina Young, PA-C

  • Physician Assistant
  • Lockport, NY
National Provider Identifier
1962207126
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
033394 Issued in NY
Practice address
3805 Lockport Olcott Rd
Lockport, NY 14094-1128
Phone
(716) 439-4248
NPI assigned
Feb 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 033394 NY Primary

Addresses

Primary practice location

3805 Lockport Olcott Rd
Lockport, NY 14094-1128

Mailing address

726 Exchange St Ste 710
Buffalo, NY 14210-1464
Phone (716) 852-4772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250429000295 NY Practitioner - Physician Assistant 7810413358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

3805 Lockport Olcott Rd
Lockport, NY 14094-1128
Phone (716) 852-4772

3898 Vineyard Dr
Dunkirk, NY 14048-3559
Phone (716) 710-8266

6009 S Transit Rd
Suite 300
Lockport, NY 14094-6307
Phone (716) 656-4077

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince Feb 23, 2025 Accepting new patients
Frederick J Piwko MD PC CurrentSince Feb 23, 2025 Accepting new patients

Locations

726 Exchange St
Ste 710
Buffalo, NY 14210
Phone (716) 343-3016

3805 Lockport Olcott Rd
Lockport, NY 14094
Phone (716) 439-4248

Interoperability endpoints

  • Direct secure messaging: ryoung@gppc.medentdirect.com

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 1

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": "1739404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1962207126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 EXCHANGE ST STE 710",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142101464",
            "telephone_number": "716-852-4772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 LOCKPORT OLCOTT RD",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140941128",
            "telephone_number": "716-439-4248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "REBECCA",
        "middle_name": "CASIMINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-13",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "033394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, NY

Sources for this page

Verify at the official NPI Registry.