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Physician Compare National (NPI:1699759159)

HEALTHCARE PROVIDER: WADE EARLE YOUNG MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1699759159
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 6608901400
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20100318000601
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name YOUNG
Individual professional last name
Provider First Name WADE
Individual professional first name
Provider Middle Name E
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name NORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
Individual professional's medical school
Graduation Year 1983
Individual professional's medical school graduation year
Primary Specialty OPHTHALMOLOGY
Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1 OPTOMETRY
First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties OPTOMETRY
All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information

Organization Legal Name WADE E YOUNG MD INC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 4789719584
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 3
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 60 ASHWOOD DR
Group Practice or individual's line 1 address
City TIFFIN
Group Practice or individual's city
State OH
Group Practice or individual's state
Zip Code 448831908
Group Practice or individual's zip code (9 digits when available)
Phone Number 4194488811
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 360089
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 MERCY TIFFIN HOSPITAL
Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment Y

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