Nathanael James Longacre

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA14987 Issued in TX

Practice address

519 N Lincoln Ave
Odessa, TX 79761-4429

Phone

(432) 640-6446

Fax

(432) 640-6493

NPI assigned

Aug 4, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Texas Tech University Health Science Center School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCH Professional CareGroup PAC ID 1658358635, 51 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical Center Hospital Hospital, Odessa, TX, CCN 450132

Merit-based Incentive Payment System (MIPS)

Final score

79.78 of 100Reported as group

Quality

60.9

Promoting interoperability

100

Improvement activities

40

Cost

66.21

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• MCH Professional Care

  • Multi-Specialty Clinic/Center
  • Odessa, TX
  • NPI 1649391269
  Medicare reassignment Care Compare group
• Basin Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Odessa, TX
  • NPI 1831337724
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ector County Hospital District

  • Federally Qualified Health Center (FQHC)
  • Odessa, TX
  • NPI 1578265302

  Hospital

  Care Compare affiliation
• Ector County Hospital District

  • General Acute Care Hospital
  • Odessa, TX
  • NPI 1740273994
  Care Compare affiliation

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1801406954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2129",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797602129",
            "telephone_number": "432-640-2408",
            "fax_number": "432-640-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 N LINCOLN AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614429",
            "telephone_number": "432-640-6446",
            "fax_number": "432-640-6493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGACRE",
        "first_name": "NATHANAEL",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-04",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Loera, COTA
• Logan Cox Inc
• Angie Long, OTR
• Benjamin Long, MD
• Rhonda Long
• Bonnie Longnecker, CRNA
• Eric Nelson Lopez Gutierrez
• Guillermo Antonio Lopez-Gonzalez, M.D.
• Enriqueta Lopez, NP
• Gilfrhen Bernard Lopez, MD

• Physician Assistant in Odessa, TX
• Providers in Odessa, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.