TIMOTHY LEE DEYOUNG MA, CCC-SLP
NPI 1538757356
Speech-Language Pathologist in Plymouth, MN
About Timothy Lee Deyoung Ma, Ccc-slp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TIMOTHY LEE DEYOUNG MA, CCC-SLP (NPI 1538757356) is an individual speech-language pathologist provider in Plymouth, Minnesota, licensed in Minnesota (10295) and active in the NPI registry since January 2021.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Timothy Lee Deyoung Ma, Ccc-slp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Timothy Deyoung reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Plymouth, MN 55447
- Reassigned Medicare billing, Minnesota enrollment
- 6 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Timothy Deyoung's NPI number?
The NPI number for Timothy Deyoung is 1538757356. It was assigned to this individual provider in the NPPES registry on January 7, 2021.
Where is Timothy Deyoung located?
Timothy Deyoung practices at 2600 Fernbrook Ln N Ste 138, Plymouth, MN 55447. The listed phone number is (952) 544-0349.
What is Timothy Deyoung's specialty?
The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.
Is Timothy Deyoung enrolled in Medicare?
Yes. Timothy Deyoung is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Timothy Deyoung's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Timothy Deyoung reassigns Medicare benefits to Autism Matters, Inc. (Plymouth, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Timothy Deyoung's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Timothy Deyoung was last updated on January 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Timothy Lee Deyoung, MA, CCC-SLP · NPI 1538757356
Speech-Language Pathologist provider in Plymouth, Minnesota. Individual provider, active in the CMS NPPES registry since January 7, 2021.
## Identity
- **NPI:** 1538757356 (Entity type: Individual)
- **Enumerated:** January 7, 2021
- **Primary specialty:** Speech-Language Pathologist · taxonomy 235Z00000X
- **State license:** 10295 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 2600 FERNBROOK LN N STE 138, Plymouth, MN 55447-4752
- **Phone:** (952) 544-0349
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Autism Matters, Inc. (NPI 1649469289, Plymouth, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 7, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1538757356) · Data from the CMS NPPES public registry.