Bethany Long

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601013144 Issued in MI

Practice address

4123 Martin Rd Ste 102
Commerce Township, MI 48390-4151

Phone

(248) 366-3700

Fax

(248) 366-1038

NPI assigned

Nov 25, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Iha Ooma Primary LLCGroup PAC ID 7012316664, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: blong4553895@direct.trinity-health.org

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.

• Iha Ooma Primary LLC

  • Family Medicine Physician
  • Bloomfield Township, MI
  • NPI 1245815984
  Medicare reassignment Care Compare group NPD (past)
• Iha Ooma Primary LLC

  • Family Medicine Physician
  • Commerce TWP, MI
  • NPI 1780470179
  NPD

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

• St Joseph Mercy Hospital-SMHC

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1053356352
  Care Compare affiliation

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1114743002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR STE J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 MARTIN RD STE 102",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483904151",
            "telephone_number": "248-366-3700",
            "fax_number": "248-366-1038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "259 Mack Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012427",
            "country_code": "US",
            "telephone_number": "313-577-1716",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4400 Highland Rd",
            "address_purpose": "LOCATION",
            "city": "Waterford",
            "state": "MI",
            "postal_code": "483281222",
            "country_code": "US",
            "telephone_number": "248-618-6000",
            "fax_number": "248-618-6951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "BETHANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-25",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601013144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifetime Dental Care of Michigan, P.C.
• Lifetime Dental Care of Michigan, P.C.
• Ericka Amy Lipman, MA., CCC-SLP
• Lisa E. Metler PH.D., P.C.
• Nandini Lohithaswa, O.D.
• Lucas Hearing LLC
• Clarita Macatula, ANP-BC
• Meghan Ann Mace, MS, OTR/L
• Alexander Macgregor, PA-C
• Shane Macphee, DC

• Physician Assistant in Commerce Township, MI
• Providers in Commerce Township, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; 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.

Verify at the official NPI Registry.