Active NPI
Long Ha Huynh, M.D., PH.D.
- Anesthesiology Physician
- Carbondale, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 036149496
- Practice address
- 405 W Jackson St
Carbondale, IL 62901-1462 - Phone
- (618) 549-0721
- Fax
- (618) 529-0449
- NPI assigned
- Jun 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD600854844 | WA | |
| Anesthesiology Physician | 207L00000X | 036149496 | IL | Primary |
Addresses
Primary practice location
405 W Jackson St
Carbondale, IL 62901-1462
Mailing address
PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 549-0752
Other practice location 1
201 S 14th St
Herrin, IL 62948-3631
Phone (618) 942-2171 ext. 65137
Other practice location 2
2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 684-3156 ext. 65137
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 214881 | Other | IL | MULTI SPECIALTY GROUP PTAN |
Other names 1
- Long Ha Huynh
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lhuynh27529@sih.direct-ci.com | ||
| Direct Messaging Address | lhuynh27529@sih.direct-ci.com | ||
| Direct Messaging Address | lhuynh27529@sih.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
221 NE Glen Oak Ave
Peoria, IL 61636-0001
5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone (309) 691-1000
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036149496 | IL | MD | Anesthesiology Physician |
| MD600854844 | WA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Methodist Medical Center of Illinois | Current | Accepting new patients | |
| Southern Illinois Medical Services, NFP | Current | Accepting new patients | |
| Methodist Medical Center of Illinois | Anesthesiology | Current | Accepting new patients |
| Carle Health Care Incorporated | Anesthesiology | Current | Accepting new patients |
Locations
2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300
405 W Jackson St
Carbondale, IL 62901
201 S 14th St
Herrin, IL 62948
Phone (618) 942-2171
2 S Hospital Dr
Murphysboro, IL 62966
Phone (618) 684-3156
5409 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-1000
221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Carle Physician Group
- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
Anesthesiology
-
dba Methodist Anesthesia Services
- Anesthesiology Physician
- Peoria, IL
- NPI 1710198379
-
dba SIH Medical Group
- Internal Medicine Physician
- Carbondale, IL
- NPI 1770656837
-
- General Acute Care Hospital
- Peoria, IL
- NPI 1164474755
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Peoria, IL
- NPI 1164474755
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606262400000",
"number": "1013112283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3988",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629023988",
"telephone_number": "618-549-0752",
"fax_number": "618-529-0449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 W JACKSON ST",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629011462",
"telephone_number": "618-549-0721",
"fax_number": "618-529-0449"
}
],
"practiceLocations": [
{
"address_1": "201 S 14th St",
"address_purpose": "LOCATION",
"city": "Herrin",
"state": "IL",
"postal_code": "629483631",
"country_code": "US",
"telephone_number": "618-942-2171 x65137",
"fax_number": "618-351-4919",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2 S Hospital Dr",
"address_purpose": "LOCATION",
"city": "Murphysboro",
"state": "IL",
"postal_code": "629663333",
"country_code": "US",
"telephone_number": "618-684-3156 x65137",
"fax_number": "618-529-0529",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUYNH",
"first_name": "LONG",
"middle_name": "HA",
"credential": "M.D., PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-18",
"last_updated": "2020-11-25",
"certification_date": "2020-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WA",
"license": "MD600854844",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "036149496",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTI SPECIALTY GROUP PTAN",
"identifier": "214881",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lhuynh27529@sih.direct-ci.com",
"affiliation": "N",
"address_1": "201 S 14th St",
"city": "Herrin",
"state": "IL",
"country_code": "US",
"postal_code": "629483631",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lhuynh27529@sih.direct-ci.com",
"affiliation": "N",
"address_1": "2 S Hospital Dr",
"city": "Murphysboro",
"state": "IL",
"country_code": "US",
"postal_code": "629663333",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lhuynh27529@sih.direct-ci.com",
"affiliation": "N",
"address_1": "405 W Jackson St",
"city": "Carbondale",
"state": "IL",
"country_code": "US",
"postal_code": "629011462",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "LONG",
"last_name": "HUYNH",
"middle_name": "HA",
"credential": "MD., PH.D.",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Carbondale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.