Dr Tristan Michael Long, OD is a medicare enrolled "Optometrist" provider in Edgerton, Wisconsin. He went to Indiana University - School Of Optometry and graduated in 2013 and has 11 years of diverse experience with area of expertise as Optometry. He is a member of the group practice Milton And Edgerton Vision Centers, Llc and his current practice location is
1110 N Main St, Edgerton, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(608) 884-3314.
Dr Tristan Michael Long is licensed to practice in Wisconsin (license number 3305-35) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1780021667.
Healthcare Provider's Profile
| Full Name | Dr Tristan Michael Long |
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| Gender | Male |
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| Speciality | Optometry |
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| Experience | 11 Years |
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| Location | 1110 N Main St, Edgerton, Wisconsin |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Tristan Michael Long attended and graduated from Indiana University - School Of Optometry in 2013
NPI Data:
- NPI Number: 1780021667
- Provider Enumeration Date: 05/31/2013
- Last Update Date: 05/31/2013
Medicare PECOS Information:
- PECOS PAC ID: 7517108715
- Enrollment ID: I20130731000392
Medical Identifiers
Medical identifiers for Dr Tristan Michael Long such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1780021667 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 3305-35 (Wisconsin) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Milton And Edgerton Vision Centers, Llc | 3072903749 | 2 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Tristan Michael Long allows following entities to bill medicare on his behalf.
| Provider Name | Michael J Long |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1093729584
PECOS PAC ID: 8325154271
Enrollment ID: I20101019001564 |
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| Provider Name | Milton & Edgerton Vision Centers, Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1194932111
PECOS PAC ID: 3072903749
Enrollment ID: O20211213000864 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Tristan Michael Long is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Tristan Michael Long, OD
8808 W Stebbinsville Rd,
Edgerton, WI 53534-8877
Ph: (608) 295-3011 | Dr Tristan Michael Long, OD
1110 N Main St,
Edgerton, WI 53534-1328
Ph: (608) 884-3314 |
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