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ANDRE LONGINO
NPI 1356738520
Student in an Organized Health Care Education/Training Program in Los Angeles, CA

Active since April 24, 2015PECOS EnrolledAccepts Medicare Assignment
11303 WILSHIRE BLVD BLDG 116, LOS ANGELES, CA 90025(310) 914-4045 Get Directions Write a Review

NPPES record last updated: April 24, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Andre Longino NPPES

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

ANDRE LONGINO (NPI 1356738520) is an individual student in an organized health care education/training program in Los Angeles, California and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1356738520
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameANDRE LONGINO
Location Address11303 WILSHIRE BLVD BLDG 116Los Angeles, CA 90025-5069
Mailing Address11303 Wilshire Blvd Bldg 116Los Angeles, CA 90025-5069
Phone(310) 914-4045
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateApril 24, 2015
✔ NPI 1356738520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
11303 WILSHIRE BLVD BLDG 116, Los Angeles, CA 90025
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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

Andre Longino 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 ID9133560790
PECOS Enrollment IDI20240514001047
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.

Psychotherapy, 30 minutes 90832
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 30-minute session, the therapist helps you explore feelings, thoughts, and behaviors to better understand yourself and manage life's challenges.
378 services23 patients
Psychiatric diagnostic evaluation 90791
A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.
12 services11 patients

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.

MR. JOHN THOMAS DERWART II
Marriage & Family Therapist
11303 WILSHIRE BLVD BLDG 116
LOS ANGELES, CA 90025
Los Angeles County (310) 914-4045
JOSH ALFRED CLEARY
Marriage & Family Therapist
11303 WILSHIRE BLVD BLDG 116
LOS ANGELES, CA 90025
Los Angeles County (310) 721-9549
LARMAR ERVIN AVILA
Rehabilitation Practitioner
11303 WILSHIRE BLVD BLDG 116
LOS ANGELES, CA 90025
Los Angeles County (310) 914-4045
DAWN MARIE JACKSON
Student in an Organized Health Care Education/Training Program
11303 WILSHIRE BLVD BLDG 116
LOS ANGELES, CA 90025
Los Angeles County (310) 903-9707
ERNEST MCFADDEN
Peer Specialist
11303 WILSHIRE BLVD BLDG 116
LOS ANGELES, CA 90025
Los Angeles County (316) 990-7046
HADASSAH HILLIARD
Student in an Organized Health Care Education/Training Program
11303 WILSHIRE BLVD BLDG 116
LOS ANGELES, CA 90025
Los Angeles County (310) 268-3465
YUN-SOOK NAVARRE
Social Worker (Clinical)
11303 WILSHIRE BLVD BLDG 116
LOS ANGELES, CA 90025
Los Angeles County (310) 210-4128
DONNIE ALBERT AGNEW
Case Manager/Care Coordinator
11303 WILSHIRE BLVD BLDG 116
LOS ANGELES, CA 90025
Los Angeles County (310) 914-4045

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 Andre Longino's NPI number?

The NPI number for Andre Longino is 1356738520. It was assigned to this individual provider in the NPPES registry on April 24, 2015.

Where is Andre Longino located?

Andre Longino practices at 11303 Wilshire Blvd Bldg 116, Los Angeles, CA 90025. The listed phone number is (310) 914-4045.

What is Andre Longino's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Andre Longino enrolled in Medicare?

Yes. Andre Longino 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 Andre Longino was last updated on April 24, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.