MISS KELLY K LONG (PA-C) – Medical Physician Assistant, NPI 1891933495
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,091 PHYSICIAN ASSISTANT in MA
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Provider Addresses for MISS KELLY K LONG (PA-C)
74;76, Chilton Street, Huron Village, West Cambridge, Cambridge, Middlesex County, Massachusetts, 02140, United States
CAMBRIDGE, MA 021386802
Phone: (781) 640-1542
Type: Mailing
Brigham and Women's Hospital, 75, Francis Street, Roxbury, Boston, Suffolk County, Massachusetts, 02115, United States
BOSTON, MA 021156110
Phone: (781) 640-1542
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: 2009-04-15
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
1
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 |
|---|---|---|---|---|
| I20090415000098 | I | Physician Assistant | MA | 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.
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 02138)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O S U R G E R Y | MD | |
| - | MA | |
| Critical Care (Intensivists), Pulmonary Disease | FL | |
| Physician Assistant | MA | |
| N E U R O L O G Y | MA | |
| Nurse Practitioner | MA | |
| Orthopedic Surgery | MA | |
| Physician Assistant | NH | |
| Nurse Practitioner | MA | |
| P A T H O L O G Y | MA |
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