Molly U Long, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9847 Issued in AZ

Practice address

1847 W Heatherbrae Dr Ste a
Phoenix, AZ 85015-4764

Phone

(602) 274-2100

Fax

(602) 535-3166

NPI assigned

Aug 19, 2006

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 names 1

• Molly M Ulrickson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Florence Wellness PLLC

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1427670751
  NPD (past)
• Conestoga Emergency Physicians LLC

  • Emergency Medicine Physician
  • Lancaster, PA
  • NPI 1275582843

  Physician Assistant

  NPD (past)
• New Jersey/Pennsylvania Em-I Medical Services, P.C.

  • Emergency Medicine Physician
  • Lititz, PA
  • NPI 1003930686

  Physician Assistant

  NPD (past)
• Red Rose Emergency Physicians LLC

  • Emergency Medicine Physician
  • Lititz, PA
  • NPI 1003865817

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1285748673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7017 S PRIEST DR APT 3091",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852836048",
            "telephone_number": "314-596-8319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1847 W HEATHERBRAE DR STE A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850154764",
            "telephone_number": "602-274-2100",
            "fax_number": "602-535-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "MOLLY",
        "middle_name": "U",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "ULRICKSON",
            "middle_name": "M",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jasmine Kim Long
• Jay Richard Long, MD
• Kim T. Long, MD
• Lori Long, PH.D., NCSP
• Marlene Long
• Natalie Long
• Stephanie Catherine Long, OD
• Tari A Long, R.N.
• Taylor A Long, DNP, APRN, CPNP-PC
• Thomas J Long, PT

• All providers in Phoenix, AZ
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.