Individual provider Active NPI

Erin Ashley Longstreth, PA-C

  • Physician Assistant
  • Kissimmee, FL
National Provider Identifier
1477274207
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9116504 Issued in FL
Practice address
410 Celebration PL Ste 305
Kissimmee, FL 34747-5436
Phone
(812) 363-4100
NPI assigned
Sep 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA9116504 FL Primary

Addresses

Primary practice location

410 Celebration PL Ste 305
Kissimmee, FL 34747-5436

Mailing address

410 Celebration PL Ste 305
Kissimmee, FL 34747-5436
Phone (812) 363-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230313002521 FL Practitioner - Physician Assistant 1456725506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

400 Celebration PL
Celebration, FL 34747-4970

410 Celebration PL
Celebration, FL 34747-5436

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9116504FLMDPhysician Assistant

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: elongstreth480457@adventhealth.direct-ci.com

Organizations & group practices 1

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 2

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": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1477274207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CELEBRATION PL STE 305",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347475436",
            "telephone_number": "812-363-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CELEBRATION PL STE 305",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347475436",
            "telephone_number": "812-363-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGSTRETH",
        "first_name": "ERIN",
        "middle_name": "ASHLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-09",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.