Individual provider Active NPI

Michael Delong, MD

  • Plastic Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1104246339
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A142610 Issued in CA
Practice address
200 UCLA Medical PLZ Ste 460
Los Angeles, CA 90095-8358
Phone
(310) 825-5582
NPI assigned
Apr 28, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X A142610 CA
Student in an Organized Health Care Education/Training Program 390200000X
Plastic Surgery Physician 208200000X A142610 CA Primary
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X A142610 CA

Addresses

Primary practice location

200 UCLA Medical PLZ Ste 460
Los Angeles, CA 90095-8358

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

757 Westwood Plz
Los Angeles, CA 90095-8358
Phone (510) 529-9431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210517001037 CA Practitioner - Plastic and Reconstructive Surgery 0648501668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Duke University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Regents of the University of CaliforniaGroup PAC ID 2264422070, 17 clinicians

Practice addresses (Care Compare)

200 UCLA Medical PLZ
Los Angeles, CA 90095-8344

Hospital & facility affiliations

  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262
  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112

Merit-based Incentive Payment System (MIPS)

Final score
79.08 of 100Reported as group
Quality
64.86
Promoting interoperability
100
Improvement activities
40
Cost
46.83

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy25
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A142610CAMDSurgery of the Hand (Plastic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Plastic Surgery CurrentSince Jul 1, 2021 Accepting new patients
UCLA Medical Group Past Accepting new patients

Locations

200 UCLA Medical Plz
Ste 460
Los Angeles, CA 90095
Phone (310) 825-5510

757 Westwood Plz
Los Angeles, CA 90095
Phone (310) 267-9448

File 54206
Los Angeles, CA 90074

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

200 UCLA Medical Plz
Ste 465
Los Angeles, CA 90095
Phone (310) 825-5510

Organizations & group practices 2

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 2

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": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1104246339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UCLA MEDICAL PLZ STE 460",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958358",
            "telephone_number": "310-825-5582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "757 Westwood Plz",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900958358",
            "country_code": "US",
            "telephone_number": "510-529-9431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELONG",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-28",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "CA",
            "license": "A142610",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A142610",
            "primary": true
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "CA",
            "license": "A142610",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.