NPIMap

Individual provider Active NPI

Joseph Longo, DO

  • Family Medicine Physician
  • Ripon, WI
National Provider Identifier
1023057320
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
52559-21 Issued in WI
Practice address
1080 W Fond Du Lac St.
CHN Medical Center - Ripon
Ripon, WI 54971
Phone
(920) 748-7000
Fax
(920) 748-7236
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 52559-21 WI Primary

Addresses

Primary practice location

1080 W Fond Du Lac St.
CHN Medical Center - Ripon
Ripon, WI 54971

Mailing address

1080 W Fond Du Lac St.
CHN Medical Center - Ripon
Ripon, WI 54971
Phone (920) 748-7000

Other identifiers 1

IdentifierTypeStateIssuer
1023057320MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100109000381 WI Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 2961406053 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Midwestern University, Chicago College of Osteopathic Med, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

1080 W Fond Du Lac St
Ripon, WI 54971-9286
Phone (920) 748-7000

Hospital & facility affiliations

  • Ascension at Home Home health agency, Neenah, WI, CCN 527009
  • Thedacare at Home Home health agency, Appleton, WI, CCN 527010
  • Generations Hospice Hospice, Fond Du Lac, WI, CCN 521590
  • SSM Health at Home Hospice Hospice, Fond Du Lac, WI, CCN 521512
  • Moments Hospice of Appleton Hospice, Appleton, WI, CCN 521606
  • Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045
  • Thedacare Medical Center - Berlin Inc Hospital, Berlin, WI, CCN 521355
  • Ripon Medical Center Hospital, Ripon, WI, CCN 521321
  • Thedacare Regional Medical Center - Appleton Inc Hospital, Appleton, WI, CCN 520160
  • Whispering Pines Nursing and Rehab, LLC Nursing home, Ripon, WI, CCN 525551

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52559-21WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated Family Medicine CurrentSince Feb 1, 2016 Accepting new patients
Thedacare Medical Center - Berlin, Inc. CurrentSince Nov 2, 2009 Accepting new patients
Thedacare Medical Center - Berlin, Inc. CurrentSince Nov 2, 2009 Accepting new patients
Trinity Physicians Group SC Family Medicine PastSince Jul 2, 2009 Accepting new patients

Locations

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

1080 W Fond du Lac St
Ripon, WI 54971
Phone (920) 748-1497

Interoperability endpoints

  • Direct secure messaging: jlongo120152@direct.thedacare.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Generations HospiceFond Du Lac, WI, CCN 521590 Hospice Contracted Managing Employee Nov 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1023057320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 W FOND DU LAC ST.",
            "address_2": "CHN MEDICAL CENTER - RIPON",
            "city": "RIPON",
            "state": "WI",
            "postal_code": "54971",
            "telephone_number": "920-748-7000",
            "fax_number": "920-748-7236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 W FOND DU LAC ST.",
            "address_2": "CHN MEDICAL CENTER - RIPON",
            "city": "RIPON",
            "state": "WI",
            "postal_code": "54971",
            "telephone_number": "920-748-7000",
            "fax_number": "920-748-7236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGO",
        "first_name": "JOSEPH",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "52559-21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023057320",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ripon, WI

Sources for this page

Verify at the official NPI Registry.