Individual provider Active NPI

Thomas J. Long, M.D.

  • Emergency Medicine Physician
  • Grass Valley, CA
National Provider Identifier
1710274964
Registry record updated May 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A124487 Issued in CA
Practice address
155 Glasson Way
Grass Valley, CA 95945-5723
Phone
(530) 274-6001
NPI assigned
Jul 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A124487 CA Primary

Addresses

Primary practice location

155 Glasson Way
Grass Valley, CA 95945-5723

Mailing address

103 Providence Mine Rd Ste 202
Nevada City, CA 95959-2949
Phone (530) 470-8377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20140702002642 CA Practitioner - Emergency Medicine 9931324092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swope Medical Group IncGroup PAC ID 2264403443, 16 clinicians

Practice addresses (Care Compare)

155 Glasson Way
Grass Valley, CA 95945-5723
Phone (530) 274-6001

Hospital & facility affiliations

  • Sierra Nevada Memorial Hospital Hospital, Grass Valley, CA, CCN 050150

Merit-based Incentive Payment System (MIPS)

Final score
94.02 of 100Reported as group
Quality
88.59
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A124487CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swope Medical Group Inc Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients

Locations

155 Glasson Way
Grass Valley, CA 95945
Phone (530) 274-6000

103 Providence Mine Rd
Ste 202
Nevada City, CA 95959
Phone (530) 470-8377

4401 W Memorial Rd
Ste 121
Oklahoma City, OK 73134
Phone (405) 749-4560

Organizations & group practices 1

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": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430697600000",
    "number": "1710274964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 PROVIDENCE MINE RD STE 202",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959592949",
            "telephone_number": "530-470-8377",
            "fax_number": "530-470-8906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 GLASSON WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455723",
            "telephone_number": "530-274-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "THOMAS",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-07",
        "last_updated": "2015-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A124487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

Verify at the official NPI Registry.