ALYSSA LONG – Certified Registered Nurse Anesthetist, NPI 1083395305

Certified Registered Nurse Anesthetist

ALYSSA LONG is a healthcare provider. based in San diego, California. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. 95002408 (CA). The NPI Number for ALYSSA LONG is 1083395305

Main info

Female

2 Years Of Experience

Accepts Medicare Assignment

Name

ALYSSA LONG

NPI

1083395305

Phone

(800) 406-4558

Address

PO BOX 509015

Enumeration Date

28 July 2023

Last Update Date

28 April 2025

Doctor Profile

Medical School Name

OTHER

Secondary Phone

7603236511

Graduation Year

2024 (2 years ago)

PAC ID

9032647722

Group Practice PAC ID

5698131969

Professional Enrollment ID

I20250108003343

Address ID

CA922624872PA1150XDRXX500

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience28

Completeness75

Years active:2State licenses:1Digital endpointsOther names

2,456 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in CA

Provider Addresses for ALYSSA LONG

PO BOX 509015
SAN DIEGO, CA 921509015
Phone: (800) 406-4558
Fax: (706) 653-1162
Type: Mailing
1150 N INDIAN CANYON DR
PALM SPRINGS, CA 922624872
Phone: (760) 323-6511
Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-01-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

Medicare enrolled
On CMS revalidation list
Due date assigned
Revalidate in PECOS

CMS enrollment records

Enrollment ID	Type	Specialty	State	Due date
I20250108003343	I	Certified Registered Nurse Anesthetist (Crna)	CA	TBD

What to do next

No action required while the due date shows TBD.
Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92150)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 5698131969View full group profile

Name	Specialty	State
MICHAEL V HALL (CRNA)	Certified Registered Nurse Anesthetist (Crna)	CA
PRAVEEN K DAVULURI (MD)	A N E S T H E S I O L O G Y	CA
DR. THOMAS C YEE (M.D.)	Pain Management, Anesthesiology, Addiction Medicine	NV
FATIMA PADRON	Certified Registered Nurse Anesthetist (Crna)	CA
MR. JUSTIN CARY JIMENEZ (RN)	Certified Registered Nurse Anesthetist (Crna)	FL
MANOJ MADHU SANGORAM (D.O.)	A N E S T H E S I O L O G Y	NY
RODRIGO FERNANDO LOPEZ (CRNA)	Certified Registered Nurse Anesthetist (Crna)	CA
MR. SOHEIL ETESHAM (MD)	A N E S T H E S I O L O G Y	CA
DENNIS C SAMSON (CRNA)	Certified Registered Nurse Anesthetist (Crna)	CA
LISA LEE CAMERINO (MD)	A N E S T H E S I O L O G Y	HI

Reviews

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Frequently asked questions

What identifier follows ALYSSA LONG across health systems?

The NPI 1083395305 uniquely identifies ALYSSA LONG in U.S. healthcare data.

Is ALYSSA LONG's NPI status active today?

Active status means ALYSSA LONG's NPI record is not deactivated in the public file.

What does the directory say ALYSSA LONG does?

Insurance directories may phrase it differently, but here ALYSSA LONG maps to Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.

Which community is linked to ALYSSA LONG?

ALYSSA LONG shows a connection to San Diego, California in registry-derived data.

Who maintains ALYSSA LONG's record?

Providers certify NPPES data; CMS hosts the public file you are viewing.