DYMOND LONG APN, FNP-BC
NPI 1114463049
Nurse Practitioner - Family in Chicago, IL

Q: What is Dymond Long's NPI number?

The NPI number for Dymond Long is 1114463049. It was assigned to this individual provider in the NPPES registry on January 17, 2017.

Q: What is Dymond Long's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Dymond Long was last updated on January 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since January 17, 2017PECOS EnrolledAccepts Medicare Assignment

1715 E 95TH ST, CHICAGO, IL 60617(773) 768-4437 Get Directions Write a Review

NPPES record last updated: January 12, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 12, 2026, Jun 27, 2025, Jun 15, 2023 and 3 more (6 updates tracked since 2017).

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About Dymond Long Apn, Fnp-bc NPPES

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

DYMOND LONG APN, FNP-BC (NPI 1114463049) is an individual family provider in Chicago, Illinois, licensed in Illinois (277001290) and active in the NPI registry since January 2017. She is enrolled in Medicare PECOS, is affiliated with Advocate Trinity Hospital, and maintains a secondary practice location in Tinley Park.

NPPES Registry Identity

NPI1114463049

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameDYMOND LONGCredential: APN, FNP-BC

Location Address1715 E 95TH STChicago, IL 60617-4708

Mailing AddressPo Box 746715Atlanta, GA 30374-6715 · (773) 352-1515 · Fax (312) 929-0373

Phone(773) 768-4437

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateJanuary 17, 2017

Last NPPES UpdateJanuary 12, 20266 updates tracked since enumeration

NPPES CertifiedJanuary 12, 2026

✔ NPI 1114463049 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in IL · 277001290✔ Licensed in IL · 209015381

1715 E 95TH ST, Chicago, IL 60617

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Secondary Practice Location 1

Location 117730 Oak Park Ave Ste BTinley Park, IL 60477-2065 · Phone (708) 998-5542 · Fax (708) 377-3940

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

Dymond Long Apn, Fnp-bc 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 ID3173807625

PECOS Enrollment IDI20180112000180

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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

74 services44 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

20 services20 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Advocate Trinity Hospital

Acute Care Hospitals · Chicago, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140048

Location2320 E 93rd StChicago, IL 60617 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60617 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TIMOTHY DAVID PRAJKA DO

Family Medicine