Baolong DO

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

134792 Issued in OK

Practice address

123 Medical Dr
Guymon, OK 73942-3606

Phone

(580) 338-3361

Fax

(580) 338-1021

NPI assigned

Oct 21, 2019

Last updated

Dec 27, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Medical CenterGroup PAC ID 7517941651, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Health Watch Health Care of Guymon, LLC Home health agency, Guymon, OK, CCN 377248
• Southwest Medical Center Hospital, Liberal, KS, CCN 170068
• Memorial Hospital of Texas County Authority Hospital, Guymon, OK, CCN 371340

Merit-based Incentive Payment System (MIPS)

Final score

83.79 of 100Reported as group

Quality

68.45

Promoting interoperability

100

Improvement activities

40

Cost

72.27

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southwest Medical Center

  dba Southwest Professional Physicians

  • Surgery Physician
  • Liberal, KS
  • NPI 1144493040

  OK

  Medicare reassignment Care Compare group NPD
• Southwest Medical Center

  dba SWMC Diagnostic Imaging

  • Diagnostic Radiology Physician
  • Liberal, KS
  • NPI 1285503078
  NPD
• Southwest Medical Center

  • General Acute Care Hospital
  • Liberal, KS
  • NPI 1538109251
  NPD (past)

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

• Health Watch Health Care of Guymon, LLC

  • Home Health Agency
  • Guymon, OK
  • NPI 1952789554
  Care Compare affiliation
• Memorial Hospital of Texas County Authority

  • Critical Access Hospital
  • Guymon, OK
  • NPI 1144205360
  Care Compare affiliation
• Southwest Medical Center

  • General Acute Care Hospital
  • Liberal, KS
  • NPI 1538109251
  Care Compare affiliation

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1891338059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1340",
            "city": "LIBERAL",
            "state": "KS",
            "postal_code": "679051340",
            "telephone_number": "620-629-6638",
            "fax_number": "620-629-6684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 MEDICAL DR",
            "city": "GUYMON",
            "state": "OK",
            "postal_code": "739423606",
            "telephone_number": "580-338-3361",
            "fax_number": "580-338-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "BAOLONG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-21",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-79076-102",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "134792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Jean Crawford, LPN
• Candace Cullop, PHARM D
• Ginger Denise Dahl, LPC
• Annette De Santiago
• Davida Danielle Deleon
• Dr W F and Mada Dunaway Manor Nursing Home of Guymon Inc (Heritage Community)
• Carah Jean Dupper, DDS
• Amy Duren
• Eaglemed, LLC
• Jason Wayne Eidson, PTA

• Family Nurse Practitioner in Guymon, OK
• Providers in Guymon, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; 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.