Individual provider Active NPI

Long Wong, MD

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1831139880
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N6775 Issued in TX
Practice address
855 Montgomery
Fort Worth, TX 76107-2553
Phone
(817) 232-9877
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25828 OK
Family Medicine Physician 207Q00000X N6775 TX Primary

Addresses

Primary practice location

855 Montgomery
Fort Worth, TX 76107-2553

Mailing address

PO Box 99335
Fort Worth, TX 76199-0335
Phone (817) 232-9877

Other identifiers 4

IdentifierTypeStateIssuer
100699860JMedicaidOK
219318701MedicaidTX
8CN568OtherTXBCBS
P01105611OtherTXRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110107000206 TX Practitioner - Family Practice 1658560545 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians
Acclaim Physician Group IncGroup PAC ID 4587963582, 520 clinicians

Practice addresses (Care Compare)

1017 W Hebron Pkwy
Carrollton, TX 75010-1113
Phone (972) 939-9495

104 S Main St
Keller, TX 76248-5003
Phone (214) 295-9385

1350 S Main St
Suite 1600
Fort Worth, TX 76104-7611
Phone (817) 702-9701

1350 S Main St FL
1 Healing Wings/Infectious Disease
Fort Worth, TX 76104-7611
Phone (817) 702-3701

1501 SW Wilshire Blvd
Burleson, TX 76028-8715
Phone (817) 295-9400

1530 N Hwy 377
Roanoke, TX 76262-9116
Phone (682) 254-9920

1559 W Main St
Lewisville, TX 75067-3394
Phone (972) 436-0333

2310 W University Dr
Suite 1500
Denton, TX 76201-1650
Phone (940) 220-5901

2751 E State Hwy 114
Southlake, TX 76092-6670
Phone (817) 749-0155

345 N Hwy 67
Cedar Hill, TX 75104-2134
Phone (972) 956-5300

3751 S I 35
Denton, TX 76210-6852
Phone (940) 383-2700

377 W Campbell Rd
Suite 100
Richardson, TX 75080-3695
Phone (469) 232-2945

3821 W Spring Creek Pkwy
Plano, TX 75023-3808
Phone (972) 599-0077

4524 W Bailey Boswell Rd
Fort Worth, TX 76179-4319
Phone (817) 720-9685

454 N Jim Wright Fwy
White Settlement, TX 76108-1437
Phone (682) 703-4505

5301 William D Tate Ave
Suite 100
Grapevine, TX 76051-7357
Phone (817) 251-2101

5644 Preston Rd
Frisco, TX 75034-7420
Phone (972) 529-4545

5653 McPherson Blvd
Fort Worth, TX 76123-6023
Phone (682) 354-3100

600 Horizon Rd
Rockwall, TX 75032-5454
Phone (972) 332-5555

720 S Main St
Keller, TX 76248-4936
Phone (817) 431-2800

7232 N Fwy
Fort Worth, TX 76137-2481
Phone (817) 439-8100

779 Grapevine Hwy
Hurst, TX 76054-2805
Phone (817) 428-7300

8450 E Fwy
Fort Worth, TX 76120-4413
Phone (817) 459-2005

8541 Davis Blvd
North Richland Hills, TX 76182-8311
Phone (817) 893-1940

Hospital & facility affiliations

  • JPS Health Network Hospital, Fort Worth, TX, CCN 450039

Merit-based Incentive Payment System (MIPS)

Final score
96.38 of 100Reported as group
Quality
80.41
Promoting interoperability
100
Improvement activities
40
Cost
78.69

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25828OKMDFamily Medicine Physician
N6775TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Health Physicians, PLLC CurrentSince Mar 1, 2020 Accepting new patients
University of North Texas Health Science Center at Fort Worth Current Accepting new patients
Acclaim Physician Group, Inc CurrentSince Nov 18, 2019 Accepting new patients
University of North Texas Health Science Center at Fort Worth Current Accepting new patients
University of North Texas Health Science Center at Fort Worth Current Accepting new patients

Locations

2310 W University Dr
#1500
Denton, TX 76201
Phone (940) 220-5901

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

5001 Mesa Springs Dr
Fort Worth, TX 76123
Phone (817) 702-0400

200 W Magnolia Ave
Ste 201
Ft Worth, TX 76104
Phone (817) 702-2450

855 Montgomery St
Ft Worth, TX 76107
Phone (817) 735-2334

104 S Main St
Keller, TX 76248
Phone (214) 295-9385

377 W Campbell Rd
Ste 100
Richardson, TX 75080
Phone (469) 232-2945

Organizations & group practices 5

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 1

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1831139880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99335",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990335",
            "telephone_number": "817-232-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 MONTGOMERY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072553",
            "telephone_number": "817-232-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "LONG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "25828",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N6775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699860J",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219318701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8CN568",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01105611",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.