Individual provider Active NPI

Kira N Long, MD

  • Vascular Surgery Physician
  • Bremerton, WA
National Provider Identifier
1992022735
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD60844358 Issued in WA
Practice address
1225 Campbell Way Ste 101
Bremerton, WA 98310-2623
Phone
(360) 479-4203
Fax
(360) 478-7240
NPI assigned
May 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 036.139358 IL
Vascular Surgery Physician 2086S0129X MD60844358 WA Primary

Addresses

Primary practice location

1225 Campbell Way Ste 101
Bremerton, WA 98310-2623

Mailing address

1225 Campbell Way Ste 101
Bremerton, WA 98310-2623
Phone (360) 479-4203

Other practice location 1

801 Broadway Ste 500
Seattle, WA 98122-4396
Phone (206) 215-5921

Other identifiers 1

IdentifierTypeStateIssuer
1992022735MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address klong646346@fhsce.catholichealth.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20181115000617 WA Practitioner - Vascular SurgeryPractitioner - General Surgery 1456642040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Boston University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1225 Campbell Way
Suite 101
Bremerton, WA 98310-3323
Phone (360) 479-4203

Hospital & facility affiliations

  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039
  • Olympic Medical Center Hospital, Port Angeles, WA, CCN 500072
  • Jefferson Healthcare Hospital, Port Townsend, WA, CCN 501323

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)30
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Nov 16, 2020 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group CurrentSince Nov 16, 2020 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

1225 Campbell Way
Ste 101
Bremerton, WA 98310
Phone (360) 479-4203

565 Eureka Way
Sequim, WA 98382
Phone (360) 582-0808

541 Eureka Way
Sequim, WA 98382
Phone (360) 582-0808

1950 NW Myhre Rd
Fl 3
Silverdale, WA 98383
Phone (564) 240-4200

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1992022735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 CAMPBELL WAY STE 101",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983102623",
            "telephone_number": "360-479-4203",
            "fax_number": "360-478-7240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 CAMPBELL WAY STE 101",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983102623",
            "telephone_number": "360-479-4203",
            "fax_number": "360-478-7240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Broadway Ste 500",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981224396",
            "country_code": "US",
            "telephone_number": "206-215-5921",
            "fax_number": "206-215-5922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "KIRA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-03",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036.139358",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WA",
            "license": "MD60844358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992022735",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klong646346@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1225 Campbell Way Ste 101",
            "city": "Bremerton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983102623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.