Jane A Longest, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C5-0000817 Issued in DE

Practice address

9715 Healthway Dr
Berlin, MD 21811

Phone

(410) 548-2343

Fax

(844) 332-3891

NPI assigned

Apr 12, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jane A Kirwan Former name

Medicare fee-for-service enrollment

Enrolled in DE

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Genesis Eldercare Physician Services LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Salisbury, MD
  • NPI 1518901933

  DE

  Medicare reassignment NPD
• Geriatric Medicine Consultants PA

  • Internal Medicine Physician
  • Greenville, DE
  • NPI 1598031643
  Medicare reassignment
• Sage Hollow Health PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Shelton, CT
  • NPI 1003700071
  NPD (past)

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

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1194041590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3177",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218023177",
            "telephone_number": "410-548-2343",
            "fax_number": "844-332-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9715 HEALTHWAY DR",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "21811",
            "telephone_number": "410-548-2343",
            "fax_number": "844-332-3891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 S Governors Ave",
            "address_2": "Suite100",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "DE",
            "postal_code": "199043530",
            "country_code": "US",
            "telephone_number": "302-526-1470",
            "fax_number": "302-674-1398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONGEST",
        "first_name": "JANE",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-12",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0000817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL -PHYSICIAN ASSISTANT",
            "identifier": "C5-0000817",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "KIRWAN",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Berlin, MD
• Providers in Berlin, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.