Data Longjohn, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

211159 Issued in NY

Practice address

1537 Straight Path
Ste102
Wyandanch, NY 11798-3414

Phone

(631) 253-0270

Fax

(631) 253-0273

NPI assigned

Feb 3, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Internal Medicine

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Skope Medical Care P.C.

  • Internal Medicine Physician
  • Wyandanch, NY
  • NPI 1356420715
  Medicare reassignment NPD Authorized official
• Central Brooklyn Medical Group PC

  dba PREFERRED HEALTH PARTNERS / AdvantageCare Physicians

  • Allergy Physician
  • New York, NY
  • NPI 1689627184

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215075882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1537 STRAIGHT PATH",
            "address_2": "STE102",
            "city": "WYANDANCH",
            "state": "NY",
            "postal_code": "117983414",
            "telephone_number": "631-253-0270",
            "fax_number": "631-253-0273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1537 STRAIGHT PATH",
            "address_2": "STE102",
            "city": "WYANDANCH",
            "state": "NY",
            "postal_code": "117983414",
            "telephone_number": "631-253-0270",
            "fax_number": "631-253-0273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGJOHN",
        "first_name": "DATA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "211159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01889129",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leticia Langdet
• Keonia Leake
• Samantha Lester, LMSW
• Arthur Calica Liclican, MD
• Linda Pressley
• Loving Arms Inc.
• Sunubia J Lucas
• Martine Macdonald
• Kelli Ann Madden
• Eugenia Manganas-Scialpi, CASAC

• Internal Medicine Physician in Wyandanch, NY
• Providers in Wyandanch, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.