NPIMap

Individual provider Active NPI

Michael Thornton Longaker, MD MBA

  • Plastic Surgery Physician
  • Stanford, CA
National Provider Identifier
1427183672
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
G57362 Issued in CA
Practice address
257 Campus Dr
Stanford, CA 94305-5101
Phone
(650) 736-1707
Fax
(650) 736-1705
NPI assigned
Feb 21, 2007
Sex
Male
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 G57362 CA Primary

Addresses

Primary practice location

257 Campus Dr
Stanford, CA 94305-5101

Mailing address

55 Shearer Dr
Atherton, CA 94027-3935
Phone (650) 365-4838

Other identifiers 1

IdentifierTypeStateIssuer
00G573620MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070509000696 CA Practitioner - Plastic and Reconstructive SurgeryPractitioner - General Surgery 2961508833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: General Surgery
Education
Harvard Medical School, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

420 Broadway St
Redwood City, CA 94063-3132
Phone (650) 723-4000

450 Broadway St
Redwood City, CA 94063-3132
Phone (650) 723-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
87.08
Promoting interoperability
100
Improvement activities
40
Cost
69.51

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G57362CAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care CurrentSince May 21, 2015 Accepting new patients
Stanford Health Care CurrentSince May 21, 2015 Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
LPCH Medical Group Div of Lucile Past Accepting new patients

Locations

450 Broadway St
Redwood City, CA 94063
Phone (650) 723-5643

450 Broadway St
Fl 2
Redwood City, CA 94063
Phone (650) 498-3931

257 Campus Dr
Stanford, CA 94305
Phone (919) 455-5849

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Interoperability endpoints

  • Direct secure messaging: mlongaker40487@direct.stanfordhealthcare.org

Organizations & group practices 5

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 7

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427183672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SHEARER DR",
            "city": "ATHERTON",
            "state": "CA",
            "postal_code": "940273935",
            "telephone_number": "650-365-4838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 CAMPUS DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943055101",
            "telephone_number": "650-736-1707",
            "fax_number": "650-736-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGAKER",
        "first_name": "MICHAEL",
        "middle_name": "THORNTON",
        "name_prefix": "Dr.",
        "credential": "MD MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G57362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G573620",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.