SANDRA J YOUNGWORTH (ANP) – Nurse Practitioner, NPI 1114910122

SANDRA J YOUNGWORTH (ANP) is a healthcare provider. based in Portland, Oregon. specializing in NURSE PRACTITIONER. They hold the professional credentials ANP. They hold a License No. AP30007006 (WA). The NPI Number for SANDRA J YOUNGWORTH (ANP) is 1114910122

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
SANDRA J YOUNGWORTH (ANP)
NPI
1114910122
Phone
(503) 494-6594
Address
3303 SW BOND AVE STE 7
Enumeration Date
24 August 2005
Last Update Date
28 January 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5034948311
Graduation Year
2005 (21 years ago)
PAC ID
8820025687
Group Practice PAC ID
4880760107
Professional Enrollment ID
I20050722000665
Address ID
OR972394501PO3303XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience87
Completeness75
Years active:20State licenses:3Digital endpointsOther names

3,366 NURSE PRACTITIONER in OR

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Provider Addresses for SANDRA J YOUNGWORTH (ANP)

  • South Bond Avenue, South Portland, Portland, Metro, Multnomah County, Oregon, 97258, United States

    PORTLAND, OR 972394501

    Phone: (503) 494-6594

    Fax: (503) 494-5385

    Type: Mailing

  • 1000 4th St SW

    Mason City, IA 504012800

    Phone: (641) 428-6300

    Fax: (641) 428-6374

    Type: Location

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: 2005-07-22

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
I20050722000665INurse PractitionerORTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes5626$0
View full utilization report →

Insurance plans in this area (ZIP 97239)

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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: 4880760107View full group profile

Reviews

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Frequently asked questions

How is SANDRA J YOUNGWORTH (ANP) identified in CMS data?
CMS-hosted NPPES data lists SANDRA J YOUNGWORTH (ANP) with NPI 1114910122.
Can I rely on SANDRA J YOUNGWORTH (ANP) being an active provider?
As of the registry snapshot, SANDRA J YOUNGWORTH (ANP) is marked active.
What is SANDRA J YOUNGWORTH (ANP) best known for clinically?
Directory data describes SANDRA J YOUNGWORTH (ANP) with Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does SANDRA J YOUNGWORTH (ANP) list a practice location?
Patients near Portland, Oregon may find SANDRA J YOUNGWORTH (ANP) in results; validate coverage separately.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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