NPIMap

Individual provider Active NPI

Charles A Longo, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Sioux Falls, SD
National Provider Identifier
1841266608
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
5192 Issued in SD
Practice address
1315 S. Cliff Ave
Ste 3000
Sioux Falls, SD 57105-1061
Phone
(605) 322-7600
Fax
(605) 322-7601
NPI assigned
Feb 23, 2006
Last updated
Dec 13, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 5192 SD Primary

Addresses

Primary practice location

1315 S. Cliff Ave
Ste 3000
Sioux Falls, SD 57105-1061

Mailing address

2400 S Minnesota Ave
Ste 100
Sioux Falls, SD 57105-3762
Phone (605) 322-7510

Other identifiers 17

IdentifierTypeStateIssuer
6004720MedicaidSD
P00095104OtherSDRR MEDICARE
028917500MedicaidMN
46022474351MedicaidNE
240862OtherSDMIDLANDS CHOICE
HP40616OtherSDHEALTHPARTNERS
0574087MedicaidIA
1909119OtherSDARAZ/ AMERICA'S PPO
3300147OtherSDMEDICA
57105Y004OtherSDWPS TRICARE
34596OtherSDSANFORD HEALTH PLAN
5192OtherSDDAKOTACARE
157L6LOOtherMNCC SYSTEMS/ BLUE PLUS
157L6LOOtherMNBLUE CROSS
20762OtherIABLUE CROSS
309991034635OtherSDPREFERRED ONE
4995936OtherSDBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031230000655 SD Practitioner - Endocrinology 6305744145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
University of Iowa, RJ & L Carver College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

1600 S Highline Ave
Sioux Falls, SD 57110-1008

1600 S Highline Ave
Suite 310
Sioux Falls, SD 57110-1007
Phone (605) 322-7600

911 E 20TH St
Suite 300
Sioux Falls, SD 57105-1045
Phone (605) 504-1100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5192SDMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Sep 2, 2003 Accepting new patients
Avera McKennan Endocrinology, Diabetes & Metabolism CurrentSince Sep 2, 2003 Accepting new patients
Avera McKennan Current Accepting new patients

Locations

2700 23rd St
Ste C
Spirit Lake, IA 51360
Phone (712) 336-3750

1315 S Cliff Ave
Ste 3000
Sioux Falls, SD 57105
Phone (605) 322-7600

911 E 20th St
Ste 300
Sioux Falls, SD 57105
Phone (605) 322-1300

Interoperability endpoints

  • Direct secure messaging: charles.longo@avera.sdhealthlink.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

  • Avera McKennan

    dba Avera McKennan Behavioral Health Clinic

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Sioux Falls, SD
    • NPI 1699009944
    Medicare reassignment Care Compare group NPD
  • Avera McKennan

    dba Avera Interventional Radiology

    • Diagnostic Radiology Physician
    • Sioux Falls, SD
    • NPI 1053680678
    NPD
  • Avera McKennan

    dba Avera Endocrinology and Diabetes

    • Endocrinology, Diabetes & Metabolism Physician
    • Sioux Falls, SD
    • NPI 1396711016
    NPD

Hospital & facility affiliations 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1841266608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S MINNESOTA AVE",
            "address_2": "STE 100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571053762",
            "telephone_number": "605-322-7510",
            "fax_number": "605-322-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 S. CLIFF AVE",
            "address_2": "STE 3000",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051061",
            "telephone_number": "605-322-7600",
            "fax_number": "605-322-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGO",
        "first_name": "CHARLES",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "SD",
            "license": "5192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6004720",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00095104",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028917500",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46022474351",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "240862",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP40616",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0574087",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ/ AMERICA'S PPO",
            "identifier": "1909119",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "3300147",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS TRICARE",
            "identifier": "57105Y004",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANFORD HEALTH PLAN",
            "identifier": "34596",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "5192",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CC SYSTEMS/ BLUE PLUS",
            "identifier": "157L6LO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "157L6LO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "20762",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "309991034635",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4995936",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.