Brent M Long, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

OA002700 Issued in PA

Practice address

2401 Park Dr Ste 101
Harrisburg, PA 17110-9303

Phone

(717) 686-9842

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX, PA, NY3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/88f6f0ad-680b-460f-ba7c-9dd496dece04/
• Direct secure messaging: blong@landmarkhealth-direct.org

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.

• Nes Medical Services of New York PC

  • Emergency Medicine Physician
  • Bath, NY
  • NPI 1215455191
  Medicare reassignment NPD
• Pine Ridge Indian Health Service Hospital

  • General Acute Care Hospital
  • Pine Ridge, SD
  • NPI 1497786412

  TX

  Medicare reassignment NPD
• Ton Sells Hospital

  • Public Health or Welfare Agency
  • Sells, AZ
  • NPI 1487652426

  TX

  Medicare reassignment NPD
• Emergency Care Services of Pennsylvania, P.C.

  • Emergency Medicine Physician
  • Langhorne, PA
  • NPI 1114955010
  Medicare reassignment
• Medical Services of Suffolk County PC

  • Emergency Medicine Physician
  • Philadelphia, PA
  • NPI 1811235724
  Medicare reassignment
• On Demand Urgent Care Group PC

  • Urgent Care Clinic/Center
  • Philadelphia, PA
  • NPI 1053729814
  Medicare reassignment
• Reading Hospital

  • Radiation Oncology Physician
  • West Reading, PA
  • NPI 1992387518
  Medicare reassignment
• St Vincent Medical Education and Research Institute Inc

  • Internal Medicine Physician
  • Erie, PA
  • NPI 1902881477
  Medicare reassignment
• Atlantic Physician Services of Maryland, P.C.

  • Physician Assistant
  • Wilmington, DE
  • NPI 1730129594

  PA

  Medicare reassignment
• Eagle Butte Indian Health Service Hospital

  • Public Health or Welfare Agency
  • Eagle Butte, SD
  • NPI 1558395848

  TX

  Medicare reassignment
• River Hospital, Inc.

  • Critical Access Hospital
  • Alexandria Bay, NY
  • NPI 1003814641
  Medicare reassignment
• Rosebud Indian Health Service

  • General Acute Care Hospital
  • Rosebud, SD
  • NPI 1194757369

  TX

  Medicare reassignment

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1508808528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 PARK DR",
            "address_2": "STE 101",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171109303",
            "telephone_number": "610-367-2259",
            "fax_number": "610-367-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 PARK DR STE 101",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171109303",
            "telephone_number": "717-686-9842"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4950 Buffalo Rd",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165102304",
            "country_code": "US",
            "telephone_number": "814-898-2576",
            "fax_number": "814-898-8790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4247 W Ridge Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165061746",
            "country_code": "US",
            "telephone_number": "814-835-2580",
            "fax_number": "814-835-2590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "BRENT",
        "middle_name": "M",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "1501096",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA001513L",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "1501096",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KS",
            "license": "1501096",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA002700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200366520A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kate Louise Locke, BSHONS LPT
• Megan McCrae Lofgren, NP
• Christopher S Lohr, CRNP
• Andrea Lomax
• Evan Nikolaos Lomis, MD
• Lindsey Rae Long, CLD
• Noah Long, PHARMD
• Sara Amber Long, OT
• Molly Ann Longacre, PA-C
• Longevity Long Term Medical Care of Pennsylvania PLLC

• Physician Assistant in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.