DIANE LONG (MD) – Specialist, NPI 1174558613
Specialist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DIANE LONG (MD)
Physicians Office Building, 6215, Humphreys Boulevard, Memphis, Shelby County, Tennessee, 38120, United States
SUITE 500
MEMPHIS, TN 381202367
Phone: (901) 682-0630
Fax: (901) 682-0635
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)
CMS reports 2 Open Payments records for all available years, with a total value of $28.
Total Amount is formed as General ($28) + Research ($0) + Ownership ($0) = $28.
Last reported payment date: 2023-03-20 • Largest payer in this snapshot: Medtronic, Inc. ($28).
Total Amount
$28
General + Research + Ownership
Payments
2
Total payment records
General Amount
$28
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $28 |
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: 2011-10-10
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 |
|---|---|---|---|---|
| I20111010000559 | I | Obstetrics/Gynecology | TN | 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 38120)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OBSTETRICS/GYNECOLOGY | TN | 76830 | Ultrasound pelvis through vagina | 29 | 27 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TN | |
| - | TN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TN | |
| - | TN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TN |
Reviews
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