Individual provider Active NPI

Paul Long, MD

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1225473226
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
266030 Issued in MA
Practice address
801 Massachusetts Avenue
Crosstown 2
Boston, MA 02118
Phone
(617) 414-4376
NPI assigned
May 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A169774 CA
Internal Medicine Physician 207R00000X 266030 MA Primary

Addresses

Primary practice location

801 Massachusetts Avenue
Crosstown 2
Boston, MA 02118

Mailing address

720 Harrison Ave.,
Dob 503
Boston, MA 02118

Other practice location 1

1001 Potrero Avenue, Bldg. 25
San Francisco, CA 94110
Phone (628) 206-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160721000603 MA Practitioner - Internal Medicine 7719119429 Reassigns benefits to 1 organization
I20210907001136 CA Practitioner - Internal Medicine 7719119429 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Utah School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Clinica de la Raza IncGroup PAC ID 1557258282, 130 clinicians

Practice addresses (Care Compare)

2000 Sierra Rd
Concord, CA 94518-2905
Phone (925) 363-2000

Hospital & facility affiliations

  • John Muir Home Health Services Home health agency, Concord, CA, CCN 057276

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A169774CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de la Raza Inc CurrentSince Oct 1, 2021 Accepting new patients
La Clinica de la Raza Inc Current Accepting new patients
University of California SFGH Medical Group Current Accepting new patients
University of California SFGH Medical Group CurrentSince Aug 1, 2021 Accepting new patients
University of California SFGH Medical Group CurrentSince Aug 1, 2021 Accepting new patients
Boston University Family Medicine, Inc. CurrentSince Jan 6, 2017 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
University of California SFGH Medical Group Internal Medicine CurrentSince Aug 1, 2021 Accepting new patients
La Clinica de la Raza Inc CurrentSince Oct 1, 2021 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
La Clinica de la Raza, Inc. Past Accepting new patients

Locations

1001 Potrero Ave
Bldg 25
San Francisco, CA 94110
Phone (415) 206-5753

1001 Potrero Ave
Rm 5H22
San Francisco, CA 94110
Phone (628) 206-4774

1001 Potrero Ave
Rm 5G1
San Francisco, CA 94110
Phone (628) 206-3503

88 Newton St
Boston, MA 02118
Phone (617) 638-7350

1 Boston Medical Ctr Pl
Roxbury, MA 02118
Phone (617) 414-5245

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: plong7387@direct.bmc.masshiway.net

Organizations & group practices 12

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 1

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": "1367539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1225473226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE.,",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MASSACHUSETTS AVENUE",
            "address_2": "CROSSTOWN 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-414-4376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Potrero Avenue, Bldg. 25",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "94110",
            "country_code": "US",
            "telephone_number": "628-206-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-03",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A169774",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "266030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.