Individual provider Active NPI

Marie Christine Longo, M.D.

  • Pediatrics Physician
  • Seattle, WA
National Provider Identifier
1790752913
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00037904 Issued in WA
Practice address
1229 Madison St
Suite 1650
Seattle, WA 98104-3586
Phone
(206) 292-2249
NPI assigned
Mar 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00037904 WA Primary

Addresses

Primary practice location

1229 Madison St
Suite 1650
Seattle, WA 98104-3586

Mailing address

1145 Broadway
Seattle, WA 98122-4201
Phone (206) 329-1760

Other practice location 1

6520 226th Pl SE Ste 100
Issaquah, WA 98027-7365
Phone (425) 394-1680

Other identifiers 1

IdentifierTypeStateIssuer
8247058MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlongo1042348@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20140429002279 WA Practitioner - Pediatric Medicine 3870726755 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00037904WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services CurrentSince Mar 1, 2014 Accepting new patients
Swedish Health Services Pediatrics CurrentSince Mar 1, 2014 Accepting new patients

Locations

21911 76th Ave W
Ste 110
Edmonds, WA 98026
Phone (425) 640-4950

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

6520 226th Pl SE
Ste 100
Issaquah, WA 98027
Phone (425) 369-0808

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

800 5th Ave
Ste 600
Seattle, WA 98104

Interoperability endpoints

  • Direct secure messaging: mlongo1042348@wm.providencedirect.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1790752913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224201",
            "telephone_number": "206-329-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 MADISON ST",
            "address_2": "SUITE 1650",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043586",
            "telephone_number": "206-292-2249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6520 226th Pl SE Ste 100",
            "address_purpose": "LOCATION",
            "city": "Issaquah",
            "state": "WA",
            "postal_code": "980277365",
            "country_code": "US",
            "telephone_number": "425-394-1680",
            "fax_number": "425-394-1674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONGO",
        "first_name": "MARIE CHRISTINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00037904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8247058",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlongo1042348@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6520 226th Pl SE Ste 100",
            "city": "Issaquah",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980277365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.