KAITLIN YOUNG (PA-C) – Medical Physician Assistant, NPI 1073055083

KAITLIN YOUNG (PA-C) is a healthcare provider. based in Staten island, New York. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 25MP00417300 (NJ). The NPI Number for KAITLIN YOUNG (PA-C) is 1073055083

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
KAITLIN YOUNG (PA-C)
NPI
1073055083
Phone
(718) 483-1951
Address
103 CRANFORD AVE
Enumeration Date
8 November 2016
Last Update Date
8 November 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8484882200
Graduation Year
2016 (10 years ago)
PAC ID
1759655814
Group Practice PAC ID
4082096334
Professional Enrollment ID
I20170928000560
Address ID
NJ077162532AT2391X36XX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

3,578 PHYSICIAN ASSISTANT in NJ

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Provider Addresses for KAITLIN YOUNG (PA-C)

  • 103, Cranford Avenue, Richmond, Staten Island, New York, 10306, United States

    STATEN ISLAND, NY 103062113

    Phone: (718) 483-1951

    Type: Mailing

  • 4248, Harbour Beach Boulevard, Brigantine, Atlantic County, New Jersey, 08203, United States

    BRIGANTINE, NJ 082031361

    Phone: (609) 266-0400

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 7 Open Payments records for all available years, with a total value of $125.

Total Amount is formed as General ($125) + Research ($0) + Ownership ($0) = $125.

Last reported payment date: 2024-10-11 • Largest payer in this snapshot: Antares Pharma, Inc. ($44).

Total Amount

$125

General + Research + Ownership

Payments

7

Total payment records

General Amount

$125

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-11

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2017-09-28

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
I20170928000560IPhysician AssistantNJTBD

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 10306)

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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: 4082096334View full group profile
NameSpecialtyState
P O D I A T R YNJ
Family PracticeNJ
Nurse PractitionerNJ
Nurse PractitionerNJ
Family PracticeVA

Reviews

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Frequently asked questions

Is there an official ID for KAITLIN YOUNG (PA-C) in U.S. healthcare records?
The official identifier for KAITLIN YOUNG (PA-C) is NPI 1073055083.
Is there an active status for KAITLIN YOUNG (PA-C)?
For scheduling context, KAITLIN YOUNG (PA-C) is shown as active in the registry.
What kind of doctor is KAITLIN YOUNG (PA-C)?
KAITLIN YOUNG (PA-C) is associated with Medical Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
Is KAITLIN YOUNG (PA-C) located near Staten Island?
KAITLIN YOUNG (PA-C) currently maps to Staten Island, New York in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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