Individual provider Active NPI

Laura Erin Long, PA-C

  • Surgical Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1528067196
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
10000583A Issued in IN
Practice address
8402 Harcourt Rd Ste 420
Indianapolis, IN 46260-2053
Phone
(317) 415-6740
NPI assigned
Jul 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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 10000583A IN
Surgical Physician Assistant 363AS0400X 10000583A IN Primary

Addresses

Primary practice location

8402 Harcourt Rd Ste 420
Indianapolis, IN 46260-2053

Mailing address

8402 Harcourt Rd Ste 420
Indianapolis, IN 46260-2053

Other names 1

  • Laura Erin North Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address laura.long.1@7598.direct.athenahealth.com ST VINCENT PHYSICIAN SERVICES HOSPITAL AND HEALTH CARE CENTER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20060510000589 IN Practitioner - Physician Assistant 9436160033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2001 W 86TH St
Indianapolis, IN 46260-1902
Phone (317) 338-2345

8240 Naab Rd
Suite 155
Indianapolis, IN 46260-1985
Phone (317) 338-7760

8402 Harcourt Rd
Indianapolis, IN 46260-2053
Phone (317) 338-4372

Hospital & facility affiliations

  • Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10000583AINMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Physician Services Hospital and Health Care Center CurrentSince Sep 1, 2011 Accepting new patients
St Vincent Physician Services Hospital and Health Care Center Physician Assistant CurrentSince Sep 1, 2011 Accepting new patients
Major Hospital Past Accepting new patients
Icem, LLC Past Accepting new patients
Saint Vincent Physician Services, Inc. Physician Assistant Past Accepting new patients

Locations

8240 Naab Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 338-7450

8402 Harcourt Rd
Ste 420
Indianapolis, IN 46260
Phone (317) 338-7200

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

8240 Naab Rd
Ste 155
Indianapolis, IN 46260
Phone (317) 338-7760

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 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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1528067196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8402 HARCOURT RD STE 420",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8402 HARCOURT RD STE 420",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602053",
            "telephone_number": "317-415-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "LAURA",
        "middle_name": "ERIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000583A",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "10000583A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "laura.long.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "ST VINCENT PHYSICIAN SERVICES HOSPITAL AND HEALTH CARE CENTER",
            "address_1": "8402 Harcourt Rd Ste 420",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462602053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "NORTH",
            "middle_name": "ERIN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.