DR. ALIX E YOUNGBLOOD (MD) – Internal Medicine Physician, NPI 1184104366

DR. ALIX E YOUNGBLOOD (MD) is a healthcare provider. based in Atlanta, Georgia. specializing in INTERNAL MEDICINE, HOSPICE/PALLIATIVE CARE. They hold the professional credentials MD. They hold a License No. 330100 (NY). The NPI Number for DR. ALIX E YOUNGBLOOD (MD) is 1184104366

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
DR. ALIX E YOUNGBLOOD (MD)
NPI
1184104366
Phone
(404) 712-2000
Address
1364 Clifton Rd NE
Enumeration Date
17 August 2018
Last Update Date
3 February 2025

Doctor Profile

Medical School Name
EMORY UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2126392000
Graduation Year
2024 (2 years ago)
PAC ID
5698176584
Group Practice PAC ID
6406755081
Professional Enrollment ID
I20250612000041
Address ID
NY100656094NE1275XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:7State licenses:1Digital endpointsOther names

5,405 INTERNAL MEDICINE in GA

Provider Addresses for DR. ALIX E YOUNGBLOOD (MD)

  • 1364 Clifton Rd NE

    Atlanta, GA 303221059

    Phone: (404) 712-2000

    Type: Location

  • 100 WOODRUFF CIR NE STE P375

    ATLANTA, GA 303221020

    Phone: (404) 727-5655

    Fax: (404) 727-0045

    Type: Mailing

  • Clifton Road Northeast, Emory Highlands, Druid Hills, DeKalb County, Georgia, 30329, United States

    ATLANTA, GA 303221059

    Phone: (404) 712-2000

    Type: Location

  • 1275 YORK AVE

    NEW YORK, NY 100656007

    Phone: (212) 639-2000

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-06-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250612000041IInternal MedicineNYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30322)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406755081View full group profile

Reviews

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Frequently asked questions

Can I cross-check DR. ALIX E YOUNGBLOOD (MD) using NPI 1184104366?
NPI 1184104366 belongs to DR. ALIX E YOUNGBLOOD (MD); compare other details if you need extra assurance.
Is there an active status for DR. ALIX E YOUNGBLOOD (MD)?
For scheduling context, DR. ALIX E YOUNGBLOOD (MD) is shown as active in the registry.
What expertise is attributed to DR. ALIX E YOUNGBLOOD (MD)?
DR. ALIX E YOUNGBLOOD (MD)'s specialty line reads Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Is DR. ALIX E YOUNGBLOOD (MD) located near Atlanta?
DR. ALIX E YOUNGBLOOD (MD) currently maps to Atlanta, Georgia in this extract.
When was this NPI issued?
Enumeration for DR. ALIX E YOUNGBLOOD (MD) is noted as August 17, 2018 where the registry provides it.

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