Individual provider Active NPI

Anthony Brian Luongo, PA-C

  • Physician Assistant
  • North Franklin, CT
National Provider Identifier
1093572877
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
82 New Park Ave
North Franklin, CT 06254-1807
Phone
(860) 889-7345
NPI assigned
Feb 28, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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 Primary

Addresses

Primary practice location

82 New Park Ave
North Franklin, CT 06254-1807

Mailing address

1238 Longmeadow St
Longmeadow, MA 01106-2202
Phone (413) 636-8037

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20240517001709 CT Practitioner - Physician Assistant 4789025081 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The William W Backus HospitalGroup PAC ID 0749170645, 248 clinicians

Practice addresses (Care Compare)

326 Washington St
Norwich, CT 06360-2740
Phone (860) 889-8331

Hospital & facility affiliations

  • William W Backus Hospital Hospital, Norwich, CT, CCN 070024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6540CTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
William W Backus Hospital CurrentSince Jul 15, 2024 Accepting new patients
Norwich Orthopedic Group, P.C. CurrentSince Jun 1, 2024 Accepting new patients
Norwich Orthopedic Group, P.C. CurrentSince Jun 1, 2024 Accepting new patients

Locations

11 Industrial Park Rd
Niantic, CT 06357
Phone (860) 391-9397

82 New Park Ave
North Franklin, CT 06254
Phone (860) 889-7345

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

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 3

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": "1709078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1093572877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1238 LONGMEADOW ST",
            "city": "LONGMEADOW",
            "state": "MA",
            "postal_code": "011062202",
            "telephone_number": "413-636-8037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 NEW PARK AVE",
            "city": "NORTH FRANKLIN",
            "state": "CT",
            "postal_code": "062541807",
            "telephone_number": "860-889-7345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUONGO",
        "first_name": "ANTHONY",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-28",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Franklin, CT

Sources for this page

Verify at the official NPI Registry.