NPIMap

Individual provider Active NPI

Adrian Long, M.D.

  • Family Medicine Physician
  • St Augustine, FL
National Provider Identifier
1346407962
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME109167 Issued in FL
Practice address
6573 A1A S
Saint Augustine, FL 32080-7504
Phone
(904) 342-7363
Fax
(904) 342-7367
NPI assigned
May 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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 ME109167 FL Primary

Addresses

Primary practice location

6573 A1A S
Saint Augustine, FL 32080-7504

Mailing address

6573 A1A S
Saint Augustine, FL 32080-7504
Phone (904) 342-7363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110722000677 FL Practitioner - Family Practice 2466620125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Crescent Beach Care, LLCGroup PAC ID 5991945289, 5 clinicians

Practice addresses (Care Compare)

6573 A1A
St Augustine, FL 32080-7504
Phone (904) 342-7363

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.78 of 100Reported as apm
Quality
77.66
Promoting interoperability
70.54
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME109167FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crescent Beach Care LLC Family Medicine CurrentSince Jul 1, 2013 Accepting new patients
Access Urgent Care LLC PastSince May 1, 2013 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

975 S Ponce de Leon Blvd
St Augustine, FL 32084
Phone (352) 694-6331

6573 A1A S
St Augustine, FL 32080
Phone (904) 325-5322

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1346407962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6573 A1A S",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320807504",
            "telephone_number": "904-342-7363",
            "fax_number": "904-342-7367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6573 A1A S",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320807504",
            "telephone_number": "904-342-7363",
            "fax_number": "904-342-7367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "ADRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-21",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME109167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.