NICHOLAS IAN LONGSTREET M.D.
NPI 1245593623
Family Medicine in Tyndall Afb, FL
About Nicholas Ian Longstreet M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NICHOLAS IAN LONGSTREET M.D. (NPI 1245593623) is an individual family medicine provider in Tyndall Afb, Florida, licensed in Nebraska (27702) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS and is a graduate of Other (2012).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Nicholas Ian Longstreet M.d. 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.
Medicare Billing Reassignment
Medicare enrollment records show Nicholas Longstreet reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fairfax, VA 22033
- Reassigned Medicare billing, District of Columbia enrollment
- 2,492 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 32403 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
TYNDALL AFB, FL 32403
TYNDALL AFB, FL 32403
PANAMA CITY, FL 32403
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 Nicholas Longstreet's NPI number?
The NPI number for Nicholas Longstreet is 1245593623. It was assigned to this individual provider in the NPPES registry on June 20, 2012.
Where is Nicholas Longstreet located?
Nicholas Longstreet practices at 340 Magnolia Cir, Tyndall Afb, FL 32403. The listed phone number is (850) 283-7232.
What is Nicholas Longstreet's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Nicholas Longstreet enrolled in Medicare?
Yes. Nicholas Longstreet 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.
Which organization bills Medicare for Nicholas Longstreet's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nicholas Longstreet reassigns Medicare benefits to Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc (Fairfax, VA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicholas Longstreet's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Nicholas Longstreet was last updated on May 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.
# Nicholas Ian Longstreet, M.D. · NPI 1245593623
Family Medicine physician in Tyndall Afb, Florida. Individual provider, active in the CMS NPPES registry since June 20, 2012.
## Identity
- **NPI:** 1245593623 (Entity type: Individual)
- **Enumerated:** June 20, 2012
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 27702 (Nebraska)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 340 MAGNOLIA CIR, Tyndall Afb, FL 32403-5604
- **Phone:** (850) 283-7232
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc (NPI 1215058326, Fairfax, VA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** May 2, 2022
---
Source: [NPI Profile](https://npiprofile.com/npi/1245593623) · Data from the CMS NPPES public registry.