Individual provider Active NPI

Mason Hoyt Long

  • Internal Medicine Physician
  • Saint Augustine, FL
National Provider Identifier
1790854537
Registry record updated Apr 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0055529 Issued in FL
Practice address
301 Health Park Blvd Ste 325
Saint Augustine, FL 32086-5771
Phone
(904) 824-6164
Fax
(904) 824-0365
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0055529 FL Primary

Addresses

Primary practice location

301 Health Park Blvd Ste 325
Saint Augustine, FL 32086-5771

Mailing address

301 Health Park Blvd Ste 325
Saint Augustine, FL 32086-5771
Phone (904) 824-6164

Other identifiers 1

IdentifierTypeStateIssuer
038939100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100422000258 FL Practitioner - Internal Medicine 0345377487

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

301 Health Park Blvd
Saint Augustine, FL 32086-5771

Hospital & facility affiliations

  • Community Home Health Care Home health agency, St Augustine, FL, CCN 107159
  • Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0055529FLMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: masonlong@mhlmd.allscriptsdirect.net
  • Direct secure messaging: mlong743065@direct.shands.ufl.edu

Hospital & facility affiliations 3

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271808000000",
    "number": "1790854537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HEALTH PARK BLVD STE 325",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865771",
            "telephone_number": "904-824-6164",
            "fax_number": "904-824-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HEALTH PARK BLVD STE 325",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865771",
            "telephone_number": "904-824-6164",
            "fax_number": "904-824-0365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "MASON",
        "middle_name": "HOYT",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2010-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0055529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038939100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Augustine, FL

Sources for this page

Verify at the official NPI Registry.