STACEY LONG (PT) – Physical Therapist, NPI 1073977716

STACEY LONG (PT) is a healthcare provider. based in Tulsa, Oklahoma. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 2734 (OK). The NPI Number for STACEY LONG (PT) is 1073977716

Main info

Female
29 Years Of Experience
Accepts Medicare Assignment
Name
STACEY LONG (PT)
NPI
1073977716
Phone
(918) 392-1482
Address
4808 S 109TH EAST AVE
Enumeration Date
8 April 2016
Last Update Date
8 April 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9183921513
Graduation Year
1997 (29 years ago)
PAC ID
8426347568
Group Practice PAC ID
9335033802
Professional Enrollment ID
I20160513000199
Address ID
OK741465822TU4808XAVEX500
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

845 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OK

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Provider Addresses for STACEY LONG (PT)

  • 4808, South 109th East Avenue, Tulsa, Tulsa County, Oklahoma, 74146, United States

    SUITE 100

    TULSA, OK 741465822

    Phone: (918) 392-1482

    Mailing address matches the actual address.

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: 2016-05-13

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160513000199IPhysical Therapist In Private PracticeOKTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes52260$0
97530Therapy procedure using functional activities37348$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes17846$0
97140Therapy procedure using manual technique, each 15 minutes11332$0
97161Evaluation for physical therapy, typically 20 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 74146)

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Provider's Procedures

STACEY LONG (PT) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYOK97001Physical therapy evaluation3636

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: 9335033802View full group profile
NameSpecialtyState
Orthopedic SurgeryOK
Sports Medicine, Family PracticeOK
Physical Therapist In Private PracticeOK
Orthopedic SurgeryOK
Sports Medicine, Family PracticeOK
R H E U M A T O L O G YOK
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeOK
Orthopedic SurgeryOK
Physical Therapist In Private PracticeOK

Reviews

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Frequently asked questions

Is there an official ID for STACEY LONG (PT) in U.S. healthcare records?
The official identifier for STACEY LONG (PT) is NPI 1073977716.
Would STACEY LONG (PT) appear as active to a payer?
You can treat STACEY LONG (PT) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to STACEY LONG (PT)?
STACEY LONG (PT)'s specialty line reads Physical Therapist. Clinical services aligned with this taxonomy classification.
What locale is associated with STACEY LONG (PT)?
Directory geography for STACEY LONG (PT) centers on Tulsa, Oklahoma.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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