Individual provider Active NPI

Wendy Tonia Longo, DO

  • Pediatrics Physician
  • Valley Stream, NY
National Provider Identifier
1518117142
Registry record updated Oct 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
260427 Issued in NY
Practice address
20 Addison PL
Valley Stream, NY 11580-5914
Phone
(516) 825-5599
NPI assigned
Sep 18, 2008
Last updated
Oct 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 260427 NY Primary

Addresses

Primary practice location

20 Addison PL
Valley Stream, NY 11580-5914

Mailing address

827 Fanwood Ave
Valley Stream, NY 11581-3101
Phone (516) 742-0898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180703001720 NY Practitioner - Pediatric Medicine 7113273236 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
260427NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Oyster Bay Pediatrics & Adolescent Medicine Past Accepting new patients
Morris Charytan MD PC Pediatrics PastSince Oct 20, 2019 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

Philadelphia, PA 19195

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570838400000",
    "number": "1518117142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 FANWOOD AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813101",
            "telephone_number": "516-742-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 ADDISON PL",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805914",
            "telephone_number": "516-825-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGO",
        "first_name": "WENDY",
        "middle_name": "TONIA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-18",
        "last_updated": "2019-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "260427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.