NPIMap

Individual provider Active NPI

Denise J Long, MD

  • Family Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1124039177
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33578 Issued in MN
Practice address
1540 Randolph Ave
Saint Paul, MN 55105-2535
Phone
(651) 699-8333
Fax
(651) 699-9257
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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 33578 MN Primary

Addresses

Primary practice location

1540 Randolph Ave
Saint Paul, MN 55105-2535

Mailing address

2025 Sloan PL Ste 35
Saint Paul, MN 55117-2092
Phone (651) 772-1572

Other identifiers 1

IdentifierTypeStateIssuer
957583900MedicaidMN

Other names 1

  • Denise Horky Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20060424000533 MN Practitioner - Family Practice 7416869532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

280 Snelling Ave N
Saint Paul, MN 55104-5330
Phone (651) 788-4444

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33578MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthservices Minnesota, P.a. Family Medicine CurrentSince Jan 1, 2008 Accepting new patients
Family Healthservices Minnesota, P.a. Family Medicine CurrentSince Jan 1, 2008 Accepting new patients

Locations

2980 Buckley Way
Inver Grove Heights, MN 55076
Phone (651) 457-2748

280 Snelling Ave N
Saint Paul, MN 55104
Phone (651) 645-3628

2025 Sloan Pl
Ste 35
Saint Paul, MN 55117
Phone (651) 772-1572

2601 Centennial Dr
Ste 100
Saint Paul, MN 55109
Phone (651) 777-7414

1540 Randolph Ave
Saint Paul, MN 55105
Phone (651) 699-8333

Interoperability endpoints

  • Direct secure messaging: denise.long@entira.eclinicaldirectplus.com

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1124039177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SLOAN PL STE 35",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551172092",
            "telephone_number": "651-772-1572",
            "fax_number": "651-772-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 RANDOLPH AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052535",
            "telephone_number": "651-699-8333",
            "fax_number": "651-699-9257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "DENISE",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "33578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "957583900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "HORKY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.