Theresa A Longo, MD

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

G59848 Issued in CA

Practice address

17575 Wicker Way
Riverside, CA 92504-9563

Phone

(951) 780-9389

Fax

(951) 780-9389

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, WI, OR3 enrollments

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 3

Specialty

Pediatric Medicine

Education

University of California, Davis School of Medicine, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hoopeston Community Memorial HospitalGroup PAC ID 3577456037, shared by 11 NPIs, 142 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tlongo201678@hisp.ehr.sutterhealth.org

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.

• Seven Star Hospital Associates Inc.

  • Diagnostic Radiology Physician
  • Hemet, CA
  • NPI 1043813140
  Medicare reassignment NPD
• Ascension NE Wisconsin, Inc

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1407803638
  Medicare reassignment NPD
• Bay Area Hospital District

  • General Acute Care Hospital
  • Coos Bay, OR
  • NPI 1225016561
  Medicare reassignment NPD
• Ascension NE Wisconsin, Inc

  • General Acute Care Hospital
  • Oshkosh, WI
  • NPI 1912527193
  NPD
• Bay Area Hospital District

  • Home Health Agency
  • North Bend, OR
  • NPI 1215018197
  NPD
• Valley Children'S Specialty Medical Group, Inc.

  • Pediatrics Physician
  • Madera, CA
  • NPI 1013968296
  NPD (past)
• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  NPD (past)
• Prosser Public Hospital District of Benton County

  • Critical Access Hospital
  • Prosser, WA
  • NPI 1306897681
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672012800000",
    "number": "1902990518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17575 WICKER WAY",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925049563",
            "telephone_number": "951-961-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17575 WICKER WAY",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925049563",
            "telephone_number": "951-780-9389",
            "fax_number": "951-780-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGO",
        "first_name": "THERESA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2022-12-26",
        "certification_date": "2022-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "G59848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kellie Loney, M.A.,BCBA
• Genevieve A Long, PA-C
• Justin Long, D.C.
• Richard Long
• Sarah Longinow
• Longs Drug Store #724/Network Pharmacy
• Longs Drug Stores California LLC
• Ranell Longshore
• Nicholas Longson
• Steven Walter Loomis, IDMT

• Pediatric Critical Care Medicine Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Pediatric Critical Care Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2022; 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.