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Deactivated NPI 1205827136 Deactivated / Inactive NPI Male Practitioner

Dr. Michael E Longevin , MD

Urology • Peoria, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Michael Longevin has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 31, 2005
NPI Deactivation Date June 16, 2021
Total Practice Duration ~16 Years of Practice (2005 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Michael Longevin, MD was a registered Urology practicing in Peoria, IL. Throughout an active medical career spanning 16 years, Dr. Longevin provided care at the practice location at 5401 N KNOXVILLE AVE until profile deactivation on 2021-06-16.

Historical Medicare Part B clinical services included established patient outpatient office visit, new patient outpatient office visit, automated urinalysis test. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

5401 N Knoxville Ave
Suite 112

Peoria, IL 616145021

Telephone 3096925828
Fax 3096925904
Associated Practice Facility / Clinic
🏢 Frank I Russo Facility NPI 1639140833

Specialty Benchmarks & Practice Insights

Comparative analytics for Urology in Peoria, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 30.8 Yrs
State Avg: 26.7 Yrs
Regional Practice Density
11 Specialists

Practicing in Peoria, IL (663 Statewide)

Telehealth Adoption Rate
18.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
50.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
61 59 $273.00 $135.53

Medical Specialties & State Licenses

Urology Primary Specialty

NUCC Taxonomy Code: 208800000X

State License IL 036-072215

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Yibing Li , MD

Physical Medicine & Rehabilitation

NPI 1013923929

Doctor of Medicine (M.D.)

Barbara Nall , APN

Nurse Practitioner - Women's Health

NPI 1053383471

Advanced Practice Nurse

Susan Gwillim , PT

Physical Therapist

NPI 1053410159

Physical Therapist

Dr. Kevin Henry , MD

Anesthesiology - Pain Medicine

NPI 1063490183

Doctor of Medicine (M.D.)

Colleen Cushing Ragon , APN, CNS

Nurse Practitioner - Family

NPI 1073804217

Advanced Practice Nurse, Clinical Nurse Specialist

Anne Waldrop , PT

Physical Therapist

NPI 1114026192

Physical Therapist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 16, 2021

Record deactivated on June 16, 2021

NPI Profile Active September 11, 2010

NPI status registered as active in NPPES database

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Updated Practice Location September 11, 2010

Registered at 5401 N KNOXVILLE AVE, SUITE 112, PEORIA, IL 616145021 (Tel: 3096925828)

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Updated Business Mailing Address September 11, 2010

Registered at 5401 N KNOXVILLE AVE, SUITE 112, PEORIA, IL 616145021 (Tel: 3096925828)

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Provider Name / Credentials Updated September 11, 2010

Recorded as MICHAEL LONGEVIN, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 11, 2010

Urology (License #036-072215 in IL)

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Initial NPI Registration & Enumeration October 31, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1205827136
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 31, 2005
Last Update: September 11, 2010
Deactivation Date: June 16, 2021

Mailing Address

5401 N Knoxville Ave, Suite 112

Peoria, IL 616145021

Phone: 3096925828

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.