NPIMap

Individual provider Active NPI

Kelly Long, PA-C

  • Physician Assistant
  • Lakewood, CO
National Provider Identifier
1740791623
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0006502 Issued in CO
Practice address
11750 W 2ND PL Ste 160
Lakewood, CO 80228-1724
Phone
(303) 430-2700
Fax
(303) 430-2770
NPI assigned
Oct 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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 PA.0006502 CO Primary

Addresses

Primary practice location

11750 W 2ND PL Ste 160
Lakewood, CO 80228-1724

Mailing address

7951 E Maplewood Ave Ste 350
Greenwood Village, CO 80111-4758
Phone (303) 930-7803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210419000979 CO Practitioner - Physician Assistant 6901163344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rocky Mountain Cancer Centers LLPGroup PAC ID 7012820533, 131 clinicians

Practice addresses (Care Compare)

11750 W 2ND Place
Suite 150
Lakewood, CO 80228-1724
Phone (303) 763-4020

3027 N Circle Dr
Colorado Springs, CO 80909-1179
Phone (719) 577-2555

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0006502COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Cancer Centers, LLP CurrentSince Mar 22, 2021 Accepting new patients
Khalid Chowdhury MD, PC PastSince Feb 12, 2013 Accepting new patients

Locations

3027 N Circle Dr
Colorado Springs, CO 80909
Phone (719) 577-2555

1800 N Williams St
Ste 200
Denver, CO 80218
Phone (303) 388-4876

1601 E 19th Ave
Ste 3000
Denver, CO 80218
Phone (303) 388-4876

7951 E Maplewood Ave
Ste 350
Greenwood Village, CO 80111

Interoperability endpoints

  • Direct secure messaging: kelly.gaydosh@rmcc.ikm.direct-ci.com

Organizations & group practices 3

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 10

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": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1740791623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7951 E MAPLEWOOD AVE STE 350",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801114758",
            "telephone_number": "303-930-7803",
            "fax_number": "303-930-5503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11750 W 2ND PL STE 160",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281724",
            "telephone_number": "303-430-2700",
            "fax_number": "303-430-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "KELLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-18",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0006502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.