Individual provider Active NPI

Benjamin Long, MD

  • Pediatrics Physician
  • Odessa, TX
National Provider Identifier
1710310289
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
V9055 Issued in TX
Practice address
520 E 6TH St
Odessa, TX 79761-4527
Phone
(432) 582-8000
NPI assigned
Aug 19, 2013
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X V9055 TX Primary
Pediatric Sleep Medicine Physician 2080S0012X 31403 NE

Addresses

Primary practice location

520 E 6TH St
Odessa, TX 79761-4527

Mailing address

1301 Concord Ter
Sunrise, FL 33323-2843

Other practice location 1

3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Phone (210) 916-7500

Other practice location 2

1100 Wilford Hall Loop Bldg 4554
Jbsa Lackland, TX 78236-5638
Phone (210) 292-6510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20200810001056 NE Order and Referring Only - Sleep MedicinePractitioner - Pediatric MedicinePractitioner - Sleep Medicine 4486079340

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Sleep Medicine
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1514 Jefferson Hwy
New Orleans, LA 70121

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
V9055TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Odessa Texas Hospital Company LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1710310289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 CONCORD TER",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E 6TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614527",
            "telephone_number": "432-582-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "Jbsa Ft Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-916-7500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Wilford Hall Loop Bldg 4554",
            "address_purpose": "LOCATION",
            "city": "Jbsa Lackland",
            "state": "TX",
            "postal_code": "782365638",
            "country_code": "US",
            "telephone_number": "210-292-6510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-19",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "V9055",
            "primary": true
        },
        {
            "code": "2080S0012X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sleep Medicine",
            "state": "NE",
            "license": "31403",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.