Individual provider Active NPI

Andrew Wallays Long, MD

  • Diagnostic Radiology Physician
  • Tucson, AZ
National Provider Identifier
1679747265
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
78295 Issued in AZ
Practice address
677 N Wilmot Rd
Tucson, AZ 85711-2701
Phone
(520) 733-7226
Fax
(520) 795-6321
NPI assigned
Apr 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X D71136 MD
Vascular & Interventional Radiology Physician 2085R0204X 274986 MA
Diagnostic Radiology Physician 2085R0202X 78295 AZ Primary

Addresses

Primary practice location

677 N Wilmot Rd
Tucson, AZ 85711-2701

Mailing address

725 North St
Pittsfield, MA 01201-4109
Phone (413) 447-2439

Other practice location 1

725 North St
Pittsfield, MA 01201-4109
Phone (413) 447-2451

Other identifiers 1

IdentifierTypeStateIssuer
51030OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101109000194 MD Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 7911051792 Reassigns benefits to 3 organizations
I20260409000226 NH Practitioner - Diagnostic Radiology 7911051792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
University of Virginia School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology LTD LLCGroup PAC ID 6204727589, 107 clinicians
Southern New Hampshire Radiology Consultants PCGroup PAC ID 2769436088, 39 clinicians

Practice addresses (Care Compare)

Mount Airy, MD 21771
Phone (520) 795-2889

6260 Quadratic Dr
Mount Airy, MD 21771-8040
Phone (603) 627-1661

703 Riverway PL
Bedford, NH 03110-6768
Phone (603) 627-1661

Hospital & facility affiliations

  • Elliot Hospital Hospital, Manchester, NH, CCN 300012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78295AZMDDiagnostic Radiology Physician
D71136MDMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology LTD., LLC Diagnostic Radiology CurrentSince Feb 1, 2026 Accepting new patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
Radia Inc P S Diagnostic Radiology Past Accepting new patients
Medical Imaging on 1St, LLC Past Accepting new patients
Department of Social Past Accepting new patients
Mercer Island Medical Imaging, LLC PastSince Nov 1, 2009 Accepting new patients
Major Hospital Past Accepting new patients
Centurion Vascular Care LLC Vascular & Interventional Radiology PastSince Feb 1, 2020 Accepting new patients

Locations

839 W Congress St
Tucson, AZ 85745
Phone (520) 670-3707

677 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 571-9599

5960 N La Cholla Blvd
Tucson, AZ 85741
Phone (520) 290-4848

2401 W Belvedere Ave
Baltimore, MD 21215

2435 W Belvedere Ave
Ste 4
Baltimore, MD 21215
Phone (410) 601-5547

2435 W Belvedere Ave
Ste 56
Baltimore, MD 21215
Phone (410) 578-8632

Organizations & group practices 9

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 1

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": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1679747265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 NORTH ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014109",
            "telephone_number": "413-447-2439",
            "fax_number": "413-496-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 N WILMOT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112701",
            "telephone_number": "520-733-7226",
            "fax_number": "520-795-6321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 North St",
            "address_purpose": "LOCATION",
            "city": "Pittsfield",
            "state": "MA",
            "postal_code": "012014109",
            "country_code": "US",
            "telephone_number": "413-447-2451",
            "fax_number": "413-496-6869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "ANDREW",
        "middle_name": "WALLAYS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-15",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MD",
            "license": "D71136",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MA",
            "license": "274986",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "78295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "51030",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.