Andre Longino

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

11303 Wilshire Blvd BLDG 116
Los Angeles, CA 90025-5069

Phone

(310) 914-4045

NPI assigned

Apr 24, 2015

Last updated

Apr 24, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Allstate Psychological and Behavioral Services

  • Clinical Psychologist
  • Los Angeles, CA
  • NPI 1386164184
  Medicare reassignment NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846
  Medicare reassignment NPD

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429833600000",
    "number": "1356738520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11303 WILSHIRE BLVD BLDG 116",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11303 WILSHIRE BLVD BLDG 116",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255069",
            "telephone_number": "310-914-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGINO",
        "first_name": "ANDRE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-24",
        "last_updated": "2015-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toni Marie Long, LCSW
• William T Long, M.D.
• Matthew Douglass Longacre, M.D.
• Longevity Medical Center
• Sarah L Longhenry
• Kendall Longino
• Donald B. Longjohn, M.D.
• Sherell M Longmire
• Elaina Longo, RADT
• Emma Longo, MD, MPH

• Student in an Organized Health Care Education/Training Program in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.