ANNA C LONG (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1063611903
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,379 NURSE PRACTITIONER in OR
Provider Addresses for ANNA C LONG (PMHNP)
3456 SE HAROLD CT
PORTLAND, OR 972024342
Phone: (855) 444-7258
Type: Location
Cafe 700, 700, Northeast Multnomah Street, Lloyd District, Portland, Metro, Multnomah County, Oregon, 97232, United States
SUITE 275
PORTLAND, OR 972322131
Phone: (503) 729-1380
Type: Mailing
3633 NE 17TH AVE
PORTLAND, OR 972122366
Phone: (503) 407-3953
Type: Mailing
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: 2025-07-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20250714001166 | I | Nurse Practitioner | OR | TBD |
| I20250715003299 | I | Nurse Practitioner | WA | 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 97202)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OH | |
| Nurse Practitioner | NJ | |
| Nurse Practitioner | NJ | |
| Nurse Practitioner | NJ | |
| Nurse Practitioner | MD | |
| Certified Clinical Nurse Specialist (Cns) | MA | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | NJ | |
| Nurse Practitioner | NJ | |
| Nurse Practitioner | LA |
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