Long Lake Podiatry PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

5901001005 Issued in MI

Legal business name

LONG LAKE PODIATRY PC

Practice address

2914 E Long Lake Rd
Troy, MI 48085-3780

Phone

(248) 528-0709

Fax

(248) 528-1807

NPI assigned

Mar 19, 2007

Organization subpart

No

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

Authorized official

Name

Amy Dooley

Title

Office Manager

Phone

(248) 528-0709

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

Tax ID family

Long Lake Podiatry PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Long Lake Podiatry PC

  • Customized Equipment (DME)
  • Troy, MI
  • NPI 1326223132
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David H Berlin, DPM

  • Foot & Ankle Surgery Podiatrist
  • Troy, MI
  • NPI 1801803309
  Medicare reassignment NPD

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759190400000",
    "number": "1962526624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2914 E LONG LAKE RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480853780",
            "telephone_number": "248-528-0709",
            "fax_number": "248-528-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2914 E LONG LAKE RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480853780",
            "telephone_number": "248-528-0709",
            "fax_number": "248-528-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG LAKE PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A",
        "authorized_official_last_name": "DOOLEY",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "248-528-0709"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901001005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5631470",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "89594B",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "480002521",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1634294",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005335144",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Lombardo, PA-C
• Linet Palayoor Lonappan, MD
• Jeffrey A London, MD
• Long Lake Anesthesiology Consultants, PLC
• Long Lake Podiatry PC
• Long Lake RX
• Long Lake RX Pharmacy LLC
• April Long, PHARMD
• Graham W Long, MD
• Victoria Ann Longton, OTR/L

• Foot & Ankle Surgery Podiatrist in Troy, MI
• Providers in Troy, MI by specialty
• Foot & Ankle Surgery Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.