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TRAVIS DAVID LONG PA
NPI 1104262781
Physician Assistant - Medical in Orange City, FL

Active since May 22, 2013PECOS EnrolledAccepts Medicare Assignment
2565 ENTERPRISE RD STE 400, ORANGE CITY, FL 32763(321) 841-6444(321) 842-1955 Get Directions Write a Review

NPPES record last updated: May 12, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 12, 2026, Mar 3, 2016 (2 updates tracked since 2016).

About Travis David Long Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRAVIS DAVID LONG PA (NPI 1104262781) is an individual medical provider in Orange City, Florida, licensed in Florida (PA9107114) and active in the NPI registry since May 2013. He is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1104262781
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameTRAVIS DAVID LONGCredential: PA
Location Address2565 ENTERPRISE RD STE 400Orange City, FL 32763-8016
Mailing Address2565 Enterprise Rd Ste 400Orange City, FL 32763-8016 · (321) 841-6444 · Fax (321) 842-1955
Phone(321) 841-6444
Fax(321) 842-1955
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateMay 22, 2013
Last NPPES UpdateMay 12, 20262 updates tracked since enumeration
NPPES CertifiedMay 12, 2026
✔ NPI 1104262781 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in FL · PA9107114
Also ListedPhysician AssistantTaxonomy 363A00000X · License PA9107114 (FL)
2565 ENTERPRISE RD STE 400, Orange City, FL 32763
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Other Identifiers 4

Medicaid0089009-00FL
Medicaid003135044AGA
Medicaid008900900FL
OtherY0HL0FL · Blue Cross Blue Shield

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Travis David Long Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5799926424
PECOS Enrollment IDI20130723000739
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Travis Long's NPI number?

The NPI number for Travis Long is 1104262781. It was assigned to this individual provider in the NPPES registry on May 22, 2013.

Where is Travis Long located?

Travis Long practices at 2565 Enterprise Rd Ste 400, Orange City, FL 32763. The listed phone number is (321) 841-6444.

What is Travis Long's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Travis Long enrolled in Medicare?

Yes. Travis Long is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Travis Long was last updated on May 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.