Individual provider Active NPI

Maria T Longo, PA

  • Physician Assistant
  • West Chester, PA
National Provider Identifier
1033489273
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA054801 Issued in PA
Practice address
1572 Wilmington Pike
West Chester, PA 19382-8371
Phone
(610) 459-3278
Fax
(781) 276-6410
NPI assigned
Jan 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA054801 PA Primary

Addresses

Primary practice location

1572 Wilmington Pike
West Chester, PA 19382-8371

Mailing address

PO Box 824301
Philadelphia, PA 19182-4031
Phone (781) 280-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120327000496 PA Practitioner - Physician Assistant 1456511500 Reassigns benefits to 4 organizations
I20190226000037 DE Practitioner - Physician Assistant 1456511500

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Regional Health NetworkGroup PAC ID 1658289517, 32 clinicians

Practice addresses (Care Compare)

108 Plaza Dr
Blandon, PA 19510-9454
Phone (610) 208-4650

Hospital & facility affiliations

  • Penn State Health St. Joseph Hospital, Reading, PA, CCN 390096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA054801PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Regional Health Network CurrentSince Apr 1, 2020 Accepting new patients
Atlantic Physician Services of Maryland, PC Physician Assistant CurrentSince Jan 6, 2020 Accepting new patients
Immediate Medical Care of Pennsylvania, LP PastSince Jun 1, 2008 Accepting new patients

Locations

108 Plaza Dr
Ste 101
Blandon, PA 19510
Phone (610) 208-4650

145 N 6th St
Fl 2
Reading, PA 19601
Phone (610) 208-4558

2500 Bernville Rd
Reading, PA 19605
Phone (610) 378-2300

Organizations & group practices 9

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": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1033489273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 824301",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191824031",
            "telephone_number": "781-280-1500",
            "fax_number": "781-276-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1572 WILMINGTON PIKE",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193828371",
            "telephone_number": "610-459-3278",
            "fax_number": "781-276-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGO",
        "first_name": "MARIA",
        "middle_name": "T",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-05",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA054801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

Verify at the official NPI Registry.