NPIMap

Individual provider Active NPI

Charles Laurence Long, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Pasadena, CA
National Provider Identifier
1780035220
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
A172378 Issued in CA
Practice address
800 S Raymond Ave
Pasadena, CA 91105-3229
Phone
(626) 795-8051
NPI assigned
Jun 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X A172378 CA Primary

Addresses

Primary practice location

800 S Raymond Ave
Pasadena, CA 91105-3229

Mailing address

703 Main St
Paterson, NJ 07503-2621
Phone (301) 980-2771

Other practice location 1

703 Main St
Paterson, NJ 07503-2621
Phone (301) 980-2771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220902001443 CA Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 6901280387 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
Georgetown University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sonora Community HospitalGroup PAC ID 4284538505, shared by 10 NPIs, 134 clinicians

Practice addresses (Care Compare)

193 Fairview LN
Sonora, CA 95370-4828
Phone (209) 536-5100

680 Guzzi LN
Suite 105
Sonora, CA 95370-5288
Phone (209) 532-0126

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A172378CAMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sonora Community Hospital CurrentSince Dec 1, 2025 Accepting new patients
Sonora Community Hospital Current Accepting new patients
Sonora Community Hospital CurrentSince Nov 1, 2025 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Mar 1, 2024 Accepting new patients
Sonora Community Hospital CurrentSince Nov 1, 2025 Accepting new patients
Congress Medical Surgery Center LLC Past Accepting new patients
Sonora Community Hospital Past Accepting new patients

Locations

289 W Huntington Dr
Ste 103
Arcadia, CA 91007
Phone (626) 821-0707

289 W Huntington Dr
Ste 304
Arcadia, CA 91007
Phone (626) 574-9745

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

800 S Raymond Ave
Fl 1
Pasadena, CA 91105

800 S Raymond Ave
Pasadena, CA 91105
Phone (626) 795-8051

680 Guzzi Ln
Ste 105
Sonora, CA 95370
Phone (209) 532-0126

193 Fairview Ln
Ste C
Sonora, CA 95370
Phone (209) 532-3124

680 Guzzi Ln
Ste 102
Sonora, CA 95370
Phone (209) 536-5780

12811 Covey Cir
Sonora, CA 95370
Phone (209) 536-1785

193 Fairview Ln
Sonora, CA 95370
Phone (209) 536-5100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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 12

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": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1780035220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "301-980-2771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S RAYMOND AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053229",
            "telephone_number": "626-795-8051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 Main St",
            "address_purpose": "LOCATION",
            "city": "Paterson",
            "state": "NJ",
            "postal_code": "075032621",
            "country_code": "US",
            "telephone_number": "301-980-2771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "CHARLES",
        "middle_name": "LAURENCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-27",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "A172378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.