Wanda K. Long, ACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

95013493 Issued in CA

Practice address

40891 Breezy Pass Rd
Palm Desert, CA 92211-7263

Phone

(757) 714-0916

NPI assigned

Jan 10, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acute Care Surgery Medical Group IncGroup PAC ID 7214006816, 205 clinicians

Fountain Valley Group Services PCGroup PAC ID 9931427382, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Desert Regional Medical Center Hospital, Palm Springs, CA, CCN 050243
• John F Kennedy Memorial Hospital Hospital, Indio, CA, CCN 050534

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wanda.long.p47@direct.mydohc.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Acute Care Surgery Medical Group, Inc.

  • Surgery Physician
  • Sacramento, CA
  • NPI 1700069549
  Medicare reassignment Care Compare group
• Fountain Valley Group Services PC

  • Hospitalist Physician
  • Indio, CA
  • NPI 1013310309
  Medicare reassignment Care Compare group
• Life Connect Medical, Inc

  • Primary Care Clinic/Center
  • Rancho Mirage, CA
  • NPI 1245489384
  Medicare reassignment NPD
• Desert Trauma Surgeons, Inc.

  • Surgical Critical Care Physician
  • Lynwood, CA
  • NPI 1144225426
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Desert Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Palm Springs, CA
  • NPI 1104856095
  Care Compare affiliation
• JFK Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Indio, CA
  • NPI 1477584993
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1003456609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40891 BREEZY PASS RD",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922117263",
            "telephone_number": "757-714-0916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40891 BREEZY PASS RD",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922117263",
            "telephone_number": "757-714-0916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "WANDA",
        "middle_name": "K.",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95013493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Llusd Dental Hygiene Program & Clinic
• LNP Consulting, Inc
• Abraham John Abad Lo Jr., M.D.
• Nolan Lo
• Loma Linda Vamc
• Christopher Lopes, DDS
• Maria Fernanda Lopez Gonzalez
• Leslie Brianna Lopez-Garcia
• Bethany Ariana Lopez
• Carolina Lopez

• Acute Care Nurse Practitioner in Palm Desert, CA
• Providers in Palm Desert, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.