Individual provider Active NPI

Kristen L. Long, PA-C

  • Physician Assistant
  • State College, PA
National Provider Identifier
1568759298
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA054968 Issued in PA
Practice address
143 Hospital Dr Ste 201
State College, PA 16803-5500
Phone
(814) 689-3140
Fax
(814) 234-0491
NPI assigned
Jul 1, 2011
Last updated
Aug 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA054968 PA Primary

Addresses

Primary practice location

143 Hospital Dr Ste 201
State College, PA 16803-5500

Mailing address

155 Wellness Way
State College, PA 16803-6702
Phone (814) 231-7000

Other practice location 1

1 Medical Center Blvd
Chester, PA 19013-3902
Phone (610) 521-4833

Other identifiers 1

IdentifierTypeStateIssuer
MA054968OtherPAPA LICENSE

Other names 1

  • Kristen Gross Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20110803000260 PA Practitioner - Physician Assistant 7315116647 Reassigns benefits to 1 organization
I20201019000910 DE Practitioner - Physician Assistant 7315116647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

129 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-3626

141 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-7322

143 Hospital Dr
State College, PA 16803-5500
Phone (814) 237-3470

155 Wellness Way
State College, PA 16803-6702

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince Oct 1, 2020 Accepting new patients
The Nemours Foundation CurrentSince Oct 1, 2020 Accepting new patients
Mount Nittany Medical Center Health Services Inc CurrentSince Aug 18, 2025 Accepting new patients
Mount Nittany Medical Center Health Services Inc Past Accepting new patients

Locations

1600 Rockland Rd
Wilmington, DE 19803

141 Medical Park Ln
Bellefonte, PA 16823
Phone (814) 355-7322

143 Hospital Dr
Ste 201
State College, PA 16803
Phone (814) 231-7888

155 Wellness Way
State College, PA 16803
Phone (800) 367-0179

1850 E Park Ave
Ste 201
State College, PA 16803
Phone (814) 234-8800

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1568759298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 WELLNESS WAY",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036702",
            "telephone_number": "814-231-7000",
            "fax_number": "814-231-7098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 HOSPITAL DR STE 201",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168035500",
            "telephone_number": "814-689-3140",
            "fax_number": "814-234-0491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Chester",
            "state": "PA",
            "postal_code": "190133902",
            "country_code": "US",
            "telephone_number": "610-521-4833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "KRISTEN",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-01",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA054968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "MA054968",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "GROSS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.