Rebecca A. Long, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002310A Issued in IN

Practice address

6097 US Highway 6
Portage, IN 46368-5215

Phone

(219) 763-1538

NPI assigned

Feb 8, 2007

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

Other identifiers 2

Other names 1

• Mrs. Rebecca A. Long-Gordon Other name

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Indiana University - School of Optometry, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Indiana LLCGroup PAC ID 5496091316, 82 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Lebanon, IN
  • NPI 1083100424
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Portage, IN
  • NPI 1780143198
  NPD
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Munster, IN
  • NPI 1922974526
  NPD

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1124168836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 CLAIRBORNE XING",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463852969",
            "telephone_number": "219-246-7807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6097 US HIGHWAY 6",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463685215",
            "telephone_number": "219-763-1538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "REBECCA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002310A",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002310B",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201034350",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11887606",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "LONG-GORDON",
            "middle_name": "A.",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Rick D Logan, LPT
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• Sharon Shaw Lowe, MA,LCPC
• Cristina Lubash, FNP
• Marcellus Maddox
• Anna Leigh Madewell, PHARMD

• Optometrist in Portage, IN
• Providers in Portage, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; 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.