Individual provider Active NPI

Alfred M Long Jr., OD

  • Optometrist
  • Marietta, GA
National Provider Identifier
1891876462
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1218 Issued in GA
Practice address
2645 Dallas Hwy
Suite 100
Marietta, GA 30064
Phone
(770) 422-8002
Fax
(770) 422-4618
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1218 GA Primary

Addresses

Primary practice location

2645 Dallas Hwy
Suite 100
Marietta, GA 30064

Mailing address

2645 Dallas Hwy
Suite 100
Marietta, GA 30064
Phone (770) 422-8002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100112000540 GA Practitioner - Optometry 0840331856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Consultants of Atlanta, PCGroup PAC ID 8426031733, 30 clinicians

Practice addresses (Care Compare)

2645 Dallas Hwy SW
Suite 100
Marietta, GA 30064-7577
Phone (770) 422-8002

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1218GAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Consultants of Atlanta, PC CurrentSince Feb 25, 2019 Accepting new patients
Eca Optical, LLC CurrentSince Feb 25, 2019 Accepting new patients
Eye Consultants of Atlanta Piedmont Past Accepting new patients
Alfred M. Long, Jr., O.D., LLC Optometrist PastSince Jul 18, 2011 Accepting new patients

Locations

3225 Cumberland Blvd SE
Ste 900
Atlanta, GA 30339
Phone (770) 394-4568

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

2645 Dallas Hwy SW
Ste 100
Marietta, GA 30064
Phone (770) 422-8002

5445 Meridian Mark Rd
Ste 220
Sandy Springs, GA 30342
Phone (404) 255-2419

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1891876462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 DALLAS HWY",
            "address_2": "SUITE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30064",
            "telephone_number": "770-422-8002",
            "fax_number": "770-422-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 DALLAS HWY",
            "address_2": "SUITE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30064",
            "telephone_number": "770-422-8002",
            "fax_number": "770-422-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "ALFRED",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.