Individual provider Active NPI

Anthony Michael Longoria, FNP

  • Family Nurse Practitioner
  • Martinez, CA
National Provider Identifier
1265557367
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12152 Issued in CA
Practice address
1000 Ward St
Martinez, CA 94553-1360
Phone
(925) 335-4707
NPI assigned
Mar 20, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12152 CA Primary

Addresses

Primary practice location

1000 Ward St
Martinez, CA 94553-1360

Mailing address

1901 Sofia CT
Brentwood, CA 94513-7226

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20110519000243 CA Order and Referring Only - Family PracticePractitioner - Family Practice 7214113679

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12152CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265557367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 SOFIA CT",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945137226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WARD ST",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945531360",
            "telephone_number": "925-335-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGORIA",
        "first_name": "ANTHONY",
        "middle_name": "MICHAEL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "12152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, CA

Sources for this page

Verify at the official NPI Registry.