Amy De Long, MD MPH

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

44246 Issued in WI

Practice address

S2845 White Eagle Lane
Baraboo, WI 53913

Phone

(608) 355-1240

Fax

(608) 356-6347

NPI assigned

Nov 6, 2006

Last updated

Feb 1, 2022By the provider in NPPES

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

Other names 1

• Amy Du Bray Professional name

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Family Practice

Education

University of Minnesota Medical School, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ho Chunk NationGroup PAC ID 5496709867, 30 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Wi Hospitals & Clinics Authority Hospital, Madison, WI, CCN 520098
• SSM Health St Clare Hospital - Baraboo Hospital, Baraboo, WI, CCN 520057
• Reedsburg Area Medical Center Hospital, Reedsburg, WI, CCN 521351

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Ho-Chunk Nation

  dba Ho-Chunk Health Care Center

  • Federally Qualified Health Center (FQHC)
  • Black River Falls, WI
  • NPI 1407911795
  Medicare reassignment Care Compare group NPD
• Ho Chunk Nation

  dba HO CHUNK NATION d/b/a House of Wellness

  • Federally Qualified Health Center (FQHC)
  • Baraboo, WI
  • NPI 1316002694
  NPD
• Dean Health Systems, Inc,

  dba Dean Clinic-Beaver Dam Family & Sports Orthopedic Center

  • Durable Medical Equipment & Medical Supplies
  • Beaver Dam, WI
  • NPI 1336425016
  NPD (past)

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

• Reedsburg Area Medical Center, Inc.

  • Family Medicine Physician
  • Reedsburg, WI
  • NPI 1457780983

  Hospital

  Care Compare affiliation
• Reedsburg Area Medical Center, Inc.

  • Critical Access Hospital
  • Reedsburg, WI
  • NPI 1891796710
  Care Compare affiliation
• SSM Health Care of Wisconsin Inc

  dba SSM Health St Clare Hospital-Baraboo

  • General Acute Care Hospital
  • Baraboo, WI
  • NPI 1386641207
  Care Compare affiliation
• University of Wisconsin Hospitals and Clinics Authority

  dba University of Wisconsin Hospital and Clinics

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1922043744
  Care Compare affiliation

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1932278090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S2845 WHITE EAGLE LANE",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "53913",
            "telephone_number": "608-355-1240",
            "fax_number": "608-356-6347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S2845 WHITE EAGLE LANE",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "53913",
            "telephone_number": "608-355-1240",
            "fax_number": "608-356-6347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LONG",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "MD MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "44246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "DU BRAY",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• County of Sauk (Sauk County Dept of Human Services)
• Karen L. Crook, COTA
• Laura Daley
• James R Damos, MD
• Kate Elizabeth Darnell, MAC
• Dean Health Systems, Inc, (SSM Health Dean Medical Group - Baraboo)
• Dean Health Systems, Inc. (SSM Health Dean Medical Group Specialty Services - Baraboo)
• Dean Health Systems, Inc. (Dean Clinic Baraboo Specialty)
• Dean Retail Services, Inc.
• Ashley Deblois, PHARMD

• Family Medicine Physician in Baraboo, WI
• Providers in Baraboo, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.