Individual provider Active NPI

David Bruce Longenecker, MD

  • Anesthesiology Physician
  • Tucson, AZ
National Provider Identifier
1003894916
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
45667 Issued in AZ
Practice address
3390 N Campbell Ave
Suite 110
Tucson, AZ 85719-2380
Phone
(520) 795-7650
NPI assigned
Jan 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD059648L PA
Anesthesiology Physician 207L00000X 45667 AZ Primary

Addresses

Primary practice location

3390 N Campbell Ave
Suite 110
Tucson, AZ 85719-2380

Mailing address

3390 N Campbell Ave
Suite 110
Tucson, AZ 85719-2380
Phone (520) 795-7650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120615000152 AZ Practitioner - Anesthesiology 3971767385 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Arizona Anesthesia Services PCGroup PAC ID 1850382565, 44 clinicians

Practice addresses (Care Compare)

3390 N Campbell Ave
Suite 110
Tucson, AZ 85719-2380
Phone (520) 795-7650

Hospital & facility affiliations

  • St Joseph'S Hospital Hospital, Tucson, AZ, CCN 030011

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group
Quality
0
Improvement activities
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45667AZMDAnesthesiology Physician
MD059648LPAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Arizona - Nogales Anesthesiology CurrentSince Sep 6, 2024 Accepting new patients
Southern Arizona Anesthesia Services, PC Anesthesiology CurrentSince Jun 1, 2012 Accepting new patients
Ias Arizona PLLC Anesthesiology CurrentSince Sep 20, 2023 Accepting new patients

Locations

3390 N Campbell Ave
Ste 110
Tucson, AZ 85719
Phone (520) 784-2243

10360 E Drexel Rd
Tucson, AZ 85747
Phone (469) 340-1366

5755 S Houghton Rd
Tucson, AZ 85747
Phone (520) 324-1727

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1003894916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 N CAMPBELL AVE",
            "address_2": "SUITE 110",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857192380",
            "telephone_number": "520-795-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 N CAMPBELL AVE",
            "address_2": "SUITE 110",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857192380",
            "telephone_number": "520-795-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGENECKER",
        "first_name": "DAVID",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD059648L",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "45667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.