Active NPI
Brian Longendyke, D.O.
- Gastroenterology Physician
- Ft Myers, FL
National Provider Identifier
1811979511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- FLOS0006673
- Practice address
- 4790 Barkley Cir
BLDG a
Ft Myers, FL 33907-7543 - Phone
- (239) 275-8882
- Fax
- (239) 275-6304
- NPI assigned
- Nov 17, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | FLOS0006673 | FL | Primary |
Addresses
Primary practice location
4790 Barkley Cir
BLDG a
Ft Myers, FL 33907-7543
Mailing address
4790 Barkley Cir
BLDG a
Ft Myers, FL 33907-7543
Phone (239) 275-8882
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811979511 | Other | FL | TRICARE |
| 205926 | Other | FL | AVMED |
| 374229600 | Medicaid | FL | |
| 80842 | Other | FL | BCBS |
| 9591507 | Other | FL | GHI |
| 100005455 | Other | FL | RAILROAD MEDICARE |
| 0971761 | Other | FL | CIGNA |
| 1131942 | Other | FL | UNITED HEALTHCARE |
| 4376307 | Other | FL | AETNA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | clinical@giaswfl.directbygreenway.com | Direct | Gastroenterology Associates of Southwest Florida LLC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| FLOS0006673 | FL | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1811979511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4790 BARKLEY CIR",
"address_2": "BLDG A",
"city": "FT MYERS",
"state": "FL",
"postal_code": "339077543",
"telephone_number": "239-275-8882",
"fax_number": "239-275-6304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4790 BARKLEY CIR",
"address_2": "BLDG A",
"city": "FT MYERS",
"state": "FL",
"postal_code": "339077543",
"telephone_number": "239-275-8882",
"fax_number": "239-275-6304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONGENDYKE",
"first_name": "BRIAN",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-17",
"last_updated": "2023-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "FL",
"license": "FLOS0006673",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "1811979511",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "205926",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "374229600",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "80842",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "9591507",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "100005455",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "0971761",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1131942",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4376307",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "clinical@giaswfl.directbygreenway.com",
"affiliation": "Y",
"endpointDescription": "Dirrect Message Address",
"affiliationName": "Gastroenterology Associates of Southwest Florida LLC",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "4790 Barkley Cir",
"address_2": "BLDG A",
"city": "Ft Myers",
"state": "FL",
"country_code": "US",
"postal_code": "339077543",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Ft Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.