Individual provider Active NPI

Kathleen Long, PA-C

  • Physician Assistant
  • Wyandotte, MI
National Provider Identifier
1245961002
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601011817 Issued in MI
Practice address
2070 Biddle Ave Ste 2
Wyandotte, MI 48192-4080
Phone
(734) 225-9100
NPI assigned
Jun 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601011817 MI Primary

Addresses

Primary practice location

2070 Biddle Ave Ste 2
Wyandotte, MI 48192-4080

Mailing address

1 Ford PL Ste 3a
Detroit, MI 48202-3450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20230705000369 MI Practitioner - Physician Assistant 2264891522 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Wyandotte HospitalGroup PAC ID 2264334499, 194 clinicians
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300

2070 Biddle Ave
Suite 2
Wyandotte, MI 48192-4080
Phone (734) 284-7482

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

  • Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Macomb Hospital Corporation CurrentSince Nov 1, 2025 Accepting new patients
Henry Ford Macomb Hospital Corporation Physician Assistant CurrentSince Nov 1, 2025 Accepting new patients
Henry Ford Health System CurrentSince Nov 1, 2025 Accepting new patients
Henry Ford Health System Physician Assistant CurrentSince Nov 1, 2025 Accepting new patients
Henry Ford Wyandotte Hospital CurrentSince Jun 28, 2023 Accepting new patients
Henry Ford Macomb Hospital Corporation Current Accepting new patients
Henry Ford Wyandotte Hospital CurrentSince Jun 28, 2023 Accepting new patients
Henry Ford Wyandotte Hospital Past Accepting new patients

Locations

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

2070 Biddle Ave
Ste 200
Wyandotte, MI 48192
Phone (734) 225-9100

2070 Biddle Ave
Ste 2
Wyandotte, MI 48192
Phone (734) 284-7482

Interoperability endpoints

  • Direct secure messaging: kkramer857524@direct.hfhs.org

Organizations & group practices 8

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 4

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": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1245961002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 BIDDLE AVE STE 2",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924080",
            "telephone_number": "734-225-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-22",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

Verify at the official NPI Registry.