Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bethany Long

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1114743002

Bethany Long is a Physician Assistant in Commerce Township, Michigan. Qualified in 2025, 1 year ago. Practices with Iha Ooma Primary LLC, a 44-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
1
Licensed in
MI
In the registry since
2024
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4123 Martin Rd Ste 102
Commerce Township, MI 48390-4151
Phone: (248) 366-3700
Fax: (248) 366-1038
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 259 Mack Ave, Detroit, MI 48201-2427 — (313) 577-1716

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601013144 (MI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1114743002
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 25, 2024
Last updated in NPPESMay 28, 2025
Certification dateMay 28, 2025
Mailing address24 Frank Lloyd Wright Dr Ste J2000, Ann Arbor, MI 48105-9484

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Iha Ooma Primary Llc — 44 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Commerce Township