Derek Scott Long, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

AR2547 Issued in AR

Practice address

115 Audubon Dr
Suite 8
Maumelle, AR 72113-7408

Phone

(501) 803-3937

Fax

(501) 803-3962

NPI assigned

Mar 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Derek S Long OD IncGroup PAC ID 0244388700, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Derek S Long OD Inc

  • Optometrist
  • North Little Rock, AR
  • NPI 1255577532
  Medicare reassignment Care Compare group Authorized official
• Derek S Long OD Inc

  • Optometrist
  • Hot Springs, AR
  • NPI 1487812392
  NPD Authorized official
• Derek S Long OD, Inc

  • Optometrist
  • Maumelle, AR
  • NPI 1043412067
  NPD Authorized official

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274659200000",
    "number": "1699734368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 AUDUBON DR",
            "address_2": "SUITE 8",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721137408",
            "telephone_number": "501-803-3937",
            "fax_number": "501-803-3962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 AUDUBON DR",
            "address_2": "SUITE 8",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721137408",
            "telephone_number": "501-803-3937",
            "fax_number": "501-803-3962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "DEREK",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2010-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "AR2547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154833722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bobby Tai Le
• Jacob Leslie, PHARMD
• Danielle M Lindley, ANP
• Lindsey Health Management, LLC
• Alethia Long
• Lyon Drug Company Maumelle Inc
• Magnolia Gem Home Health
• Maje Home Care Agency
• Maumelle Alf Opco LLC
• Maumelle Chiropractic Inc

• Optometrist in Maumelle, AR
• Providers in Maumelle, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.