NPIMap

Individual provider Active NPI

Rachael Olivia Long

  • Family Medicine Physician
  • Brooklyn Park, MN
National Provider Identifier
1295025716
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
55362 Issued in MN
Practice address
9300 Noble Pkwy N
Brooklyn Park, MN 55443-5500
Phone
(763) 236-5300
Fax
(763) 236-5250
NPI assigned
Apr 18, 2011
Last updated
Nov 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 55362 MN Primary

Addresses

Primary practice location

9300 Noble Pkwy N
Brooklyn Park, MN 55443-5500

Mailing address

6600 Excelsior Blvd
Suite 160
St Louis Park, MN 55426-4744
Phone (952) 993-7711

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rlong105380@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20121210000049 MN Practitioner - Family Practice 9234381757 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System Family Medicine Current Accepting new patients
Fairview Health Services CurrentSince May 26, 2013 Accepting new patients
Allina Health System CurrentSince Oct 6, 2014 Accepting new patients
Allina Health System CurrentSince Oct 6, 2014 Accepting new patients
Allina Health System Family Medicine Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

9300 Noble Pkwy N
Minneapolis, MN 55443
Phone (763) 236-5300

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

Interoperability endpoints

  • Direct secure messaging: rlong105380@excellian.direct.allina.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1295025716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 EXCELSIOR BLVD",
            "address_2": "SUITE 160",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264744",
            "telephone_number": "952-993-7711",
            "fax_number": "952-993-6798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 NOBLE PKWY N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554435500",
            "telephone_number": "763-236-5300",
            "fax_number": "763-236-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "RACHAEL",
        "middle_name": "OLIVIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-18",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "55362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rlong105380@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "9300 Noble Pkwy N",
            "city": "Brooklyn Park",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554435500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn Park, MN

Sources for this page

Verify at the official NPI Registry.