Jayme Nicole Kasting Long, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3443-35 Issued in WI

Practice address

641 E Saint Mary St
Milton, WI 53563-3719

Phone

(608) 868-4651

Fax

(608) 884-4923

NPI assigned

Jun 17, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jayme.long@direct.revolutionehr.com

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.

• Milton & Edgerton Vision Centers, LLC

  • Optometrist
  • Edgerton, WI
  • NPI 1194932111
  Medicare reassignment NPD Authorized official
• Milton & Edgerton Vision Centers, LLC

  • Optometrist
  • Milton, WI
  • NPI 1245449644
  NPD Authorized official
• Eye Associates of Southern Indiana PC

  • Durable Medical Equipment & Medical Supplies
  • New Albany, IN
  • NPI 1083607592

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1497169403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 NORTH MAIN STREET",
            "city": "EDGERTON",
            "state": "WI",
            "postal_code": "535341328",
            "telephone_number": "608-884-3314",
            "fax_number": "608-884-4923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 E SAINT MARY ST",
            "city": "MILTON",
            "state": "WI",
            "postal_code": "535633719",
            "telephone_number": "608-868-4651",
            "fax_number": "608-884-4923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1110 North Main Street",
            "address_2": "Apartment, suite, unit, building, floor",
            "address_purpose": "LOCATION",
            "city": "Edgerton",
            "state": "WI",
            "postal_code": "535345353",
            "country_code": "US",
            "telephone_number": "608-884-3314",
            "fax_number": "608-884-4923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "JAYME",
        "middle_name": "NICOLE KASTING",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003848A",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3443-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Kerkman
• Carly A Kling, DPT
• Arlene Koniecki, RN
• Lake Geneva Dental Care, LLC
• Blake Aaron Lemay, OD
• Lauren Renee Loofboro, LPN
• Diana Martingilio, APNP
• Rachel Mildred McKinley, OT
• Mercy Health System Corporation
• Mercy Health System Corporation

• Optometrist in Milton, WI
• Providers in Milton, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.