Individual provider Active NPI

Kimlyn Long, MD

  • Plastic Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1306902648
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
191631 Issued in NY
Practice address
983 Fulton St
Brooklyn, NY 11238-2408
Phone
(718) 398-6400
Fax
(718) 398-6411
NPI assigned
Dec 29, 2006
Sex
Female
Sole proprietor
Yes

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
Plastic Surgery Physician 208200000X 191631 NY Primary

Addresses

Primary practice location

983 Fulton St
Brooklyn, NY 11238-2408

Mailing address

983 Fulton St
Brooklyn, NY 11238-2408
Phone (718) 398-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050317000943 NY Practitioner - Plastic and Reconstructive Surgery 5193770535 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles (8 of 12)

OrganizationSpecialtyStatusNew patients
Physicians of University Hospital PC CurrentSince Jun 1, 2008 Accepting new patients
Physicians of University Hospital, PC Plastic Surgery Current Accepting new patients
Urgent Surgical Care, PLLC Plastic Surgery Current Accepting new patients
Physicians of University Hospital, PC CurrentSince Jun 1, 2008 Accepting new patients
North Shore-Lij Medical PC CurrentSince Jun 1, 2019 Accepting new patients
Kimlyn Long MD, PLLC Plastic Surgery Current Accepting new patients
Asklipios Medical Group, LLP Past Accepting new patients
Lenox Hill Hospital Past Accepting new patients

Locations

17561 Hillside Ave
Ste 202
Jamaica, NY 11432
Phone (718) 291-4800

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

300 Community Dr
Plandome, NY 11030

401 Seaview Ave
Lowr
Staten Island, NY 10305
Phone (718) 226-6186

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047

501 Seaview Ave
Staten Island, NY 10305
Phone (718) 667-4700

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: klong103397@northwell.direct-ci.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306902648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "983 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112382408",
            "telephone_number": "718-398-6400",
            "fax_number": "718-398-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "983 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112382408",
            "telephone_number": "718-398-6400",
            "fax_number": "718-398-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "KIMLYN",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "191631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.