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

Russell Longendorfer, PA-C

Individual provider Physician Assistant · NPI 1194249136

Russell Longendorfer, PA-C is a Physician Assistant in Worcester, Massachusetts. Qualified in 2017, 9 years ago. Practices with Umass Memorial Medical Group Inc, a 2,467-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Connecticut and Massachusetts.

Years since qualifying
9
Licensed in
CT, MA
In the registry since
2017
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

55 Lake Ave N
Worcester, MA 01655-0002
Phone: (774) 443-7552
Fax: (774) 441-6086
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 80 Seymour St, Hartford, CT 06106-3315 — (508) 851-0809
  • 119 Belmont St, Worcester, MA 01605-2903 — (774) 443-7552

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA8684 (MA)
Physician Assistant Taxonomy 363A00000X
Physician Assistant Taxonomy 363A00000X · Licence 3945 (CT)

Record details

NPI number1194249136
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 1, 2017
Last updated in NPPESApril 21, 2022
Certification dateApril 21, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Umass Memorial Medical Group Inc — 2467 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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