Individual provider Active NPI

Zachary Long, DO

  • Plastic and Reconstructive Surgery Physician
  • Honolulu, HI
National Provider Identifier
1295142453
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
DOS-2075 Issued in HI
Practice address
1330 Ala Moana Blvd FL 4
Honolulu, HI 96814-4200
Phone
(808) 585-8855
NPI assigned
Jul 18, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 282554 MA
Plastic and Reconstructive Surgery Physician 2086S0122X DR.0072833 CO
Plastic and Reconstructive Surgery Physician 2086S0122X DOS-2075 HI Primary

Addresses

Primary practice location

1330 Ala Moana Blvd FL 4
Honolulu, HI 96814-4200

Mailing address

1330 Ala Moana Blvd FL 4
Honolulu, HI 96814-4200
Phone (808) 585-8855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20200916001911 MA Practitioner - Plastic and Reconstructive Surgery 2860810215 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0072833COMDPlastic and Reconstructive Surgery Physician
DOS-2075HIMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Berkshire Faculty Services Inc CurrentSince Aug 10, 2020 Accepting new patients
Fairview Hospital CurrentSince Aug 10, 2020 Accepting new patients

Locations

780 S Main St
Ste 2
Gt Barrington, MA 01230
Phone (413) 447-2498

55 Pittsfield Rd
Ste 12C
Lenox, MA 01240
Phone (413) 344-1750

777 North St
Ste 407
Pittsfield, MA 01201
Phone (413) 445-6420

725 North St
Pittsfield, MA 01201
Phone (413) 447-2839

Interoperability endpoints

  • Direct secure messaging: zacharylong@bfs.medalliesdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1295142453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 ALA MOANA BLVD FL 4",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144200",
            "telephone_number": "808-585-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 ALA MOANA BLVD FL 4",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144200",
            "telephone_number": "808-585-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "ZACHARY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-18",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MA",
            "license": "282554",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CO",
            "license": "DR.0072833",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "HI",
            "license": "DOS-2075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.