NPIMap

Individual provider Active NPI

Eric Long, D.O.

  • Anesthesiology Physician
  • Oklahoma City, OK
National Provider Identifier
1225090343
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4210 Issued in OK
Practice address
4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone
(405) 636-7000
NPI assigned
Apr 4, 2006
Last updated
Aug 23, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4210 OK Primary

Addresses

Primary practice location

4401 S Western Ave
Oklahoma City, OK 73109-3413

Mailing address

PO Box 891661
Oklahoma City, OK 73189-1661
Phone (918) 200-9450

Other practice location 1

920 Stanton L Young Blvd # Wp1140
Oklahoma City, OK 73104-5036
Phone (405) 271-4351

Other identifiers 1

IdentifierTypeStateIssuer
200031890AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20040712000388 OK Practitioner - Anesthesiology 6305824822 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Oklahoma State University College of Osteopathic Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Medical Professionals PLLCGroup PAC ID 5991970279, 103 clinicians

Practice addresses (Care Compare)

4801 Integris Pkwy
Edmond, OK 73034-8864
Phone (405) 713-4565

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4210OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Aug 12, 2019 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Aug 12, 2019 Accepting new patients
Anesthesia Medical Professionals, PLLC Anesthesiology CurrentSince Jan 1, 2016 Accepting new patients
Ronald G Powell MD PC Anesthesiology Past Accepting new patients

Locations

4801 Integris Pkwy
Edmond, OK 73034
Phone (405) 657-3000

4401 S Western Ave
Oklahoma City, OK 73109
Phone (405) 636-7000

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

920 Stanton L Young Blvd
Oklahoma City, OK 73104
Phone (405) 271-5251

920 Stanton L Young Blvd
#1140
Oklahoma City, OK 73104
Phone (405) 271-4515

920 Stanton L Young Blvd
Ste 1140
Oklahoma City, OK 73104

Interoperability endpoints

  • Direct secure messaging: elong29686@direct.integrisok.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1225090343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 891661",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731891661",
            "telephone_number": "918-200-9450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093413",
            "telephone_number": "405-636-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Stanton L Young Blvd # Wp1140",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731045036",
            "country_code": "US",
            "telephone_number": "405-271-4351",
            "fax_number": "405-271-8695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "ERIC",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "4210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200031890A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.