Active NPI 1376534917 Individual Practitioner Male Practitioner

Dr. Jack Calhoun Long , MD

Urology • Georgetown, TX

Professional Overview & Biography Verified Profile Summary

Dr. Jack Long, MD is a registered healthcare professional specializing in Urology in Georgetown, TX. Practice services are available at 1900 SCENIC DR STE 1114 under active NPI credentials.

Frequently performed procedures and clinical services include chronic care management services, first, automated urinalysis test, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1900 Scenic Dr Ste 1114

Georgetown, TX 786267724

Telephone 5122482200

Fax 5122481950

Associated Practice Facility / Clinic

🏢 Urology Austin, Pllc Facility NPI 1932843505

Specialty Benchmarks & Practice Insights

Comparative analytics for Urology in Georgetown, TX

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 11.0 Yrs

State Avg: 25.2 Yrs

Regional Practice Density

2 Specialists

Practicing in Georgetown, TX (1027 Statewide)

Telehealth Adoption Rate

50.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

47.3% 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 (2022)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	238	62	$76.82	$62.23
81003 Automated urinalysis test	220	177	$7.00	$2.24
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	111	96	$249.00	$126.32
51798 Ultrasound measurement of bladder capacity after voiding	94	80	$44.00	$10.20
99213 Established patient office or other outpatient visit, typically 15 minutes	73	68	$168.00	$89.28
99439 Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month	64	39	$77.40	$47.02
36415 Insertion of needle into vein for collection of blood sample	38	36	$15.00	$2.98
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	24	24	$380.00	$164.24
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	21	20	$101.00	$55.54
52000 Diagnostic exam of bladder and urethra using an endoscope	14	14	$477.00	$243.79
99426 Principal care management services for a single high-risk disease, first 30 minutes of clinical staff time directed by health care professional, per calendar month	14	12	$82.00	$60.97
76872 Ultrasound scan of pelvic region through rectum	13	13	$229.23	$139.59

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	701	106	$55.90	$40.02
81003 Automated urinalysis test	624	409	$7.00	$2.25
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	333	248	$249.00	$127.05
51798 Ultrasound measurement of bladder capacity after voiding	318	239	$44.00	$9.94
99213 Established patient office or other outpatient visit, typically 15 minutes	206	179	$168.00	$89.21
99439 Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month	124	70	$55.00	$36.57
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	51	51	$380.00	$164.05
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	46	39	$101.00	$55.13
52000 Diagnostic exam of bladder and urethra using an endoscope	38	34	$477.00	$232.18
76872 Ultrasound scan of pelvic region through rectum	23	23	$220.00	$137.69
36415 Insertion of needle into vein for collection of blood sample	20	19	$15.00	$3.00

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	1,068	189	$55.90	$40.98
81003 Automated urinalysis test	466	356	$7.00	$2.23
99213 Established patient office or other outpatient visit, typically 15 minutes	363	308	$168.00	$73.47
51798 Ultrasound measurement of bladder capacity after voiding	350	288	$44.00	$9.88
G2058 Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure). (do not report g2058 fo	254	139	$55.00	$36.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	131	117	$249.00	$106.90
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	76	68	$101.00	$43.45
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	72	72	$380.00	$160.42
52000 Diagnostic exam of bladder and urethra using an endoscope	48	46	$477.00	$207.70
76872 Ultrasound scan of pelvic region through rectum	30	30	$220.00	$140.60
36415 Insertion of needle into vein for collection of blood sample	19	18	$15.00	$2.97
81001 Manual urinalysis test with examination using microscope, automated	18	17	$10.00	$3.14
55700 Biopsy of prostate gland	13	13	$508.00	$246.85

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	1,188	12	$1.00	$0.11
81003 Automated urinalysis test	859	576	$7.00	$2.44
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	561	149	$89.47	$40.48
99213 Established patient office or other outpatient visit, typically 15 minutes	515	408	$168.00	$71.74
51798 Ultrasound measurement of bladder capacity after voiding	452	339	$44.00	$12.04
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	141	141	$380.00	$160.07
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	127	112	$249.00	$105.76
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	71	66	$101.00	$43.56
52000 Diagnostic exam of bladder and urethra using an endoscope	62	59	$477.00	$183.78
36415 Insertion of needle into vein for collection of blood sample	56	52	$15.00	$2.89
J1580 Injection, garamycin, gentamicin, up to 80 mg	51	25	$5.00	$1.78
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	48	34	$59.00	$16.13
76872 Ultrasound scan of pelvic region through rectum	48	48	$220.00	$123.04
81001 Manual urinalysis test with examination using microscope, automated	39	36	$10.00	$3.45
55700 Biopsy of prostate gland	24	24	$508.00	$243.49
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	24	24	$140.00	$55.40
51700 Simple bladder irrigation and/or instillation	18	17	$194.00	$72.30
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	13	12	$46.00	$21.88
74178 Ct scan of abdomen and pelvis before and after contrast	12	12	$607.58	$232.90
74176 Ct scan of abdomen and pelvis without contrast	11	11	$280.55	$96.80

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81003 Automated urinalysis test	904	568	$7.00	$2.71
99213 Established patient office or other outpatient visit, typically 15 minutes	543	434	$168.00	$70.40
51798 Ultrasound measurement of bladder capacity after voiding	263	182	$44.00	$14.92
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	168	168	$380.00	$158.22
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	131	101	$101.00	$42.13
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	113	100	$249.00	$103.92
36415 Insertion of needle into vein for collection of blood sample	77	73	$15.00	$2.91
52000 Diagnostic exam of bladder and urethra using an endoscope	58	53	$477.00	$158.40
J0696 Injection, ceftriaxone sodium, per 250 mg	52	13	$3.00	$0.63
76872 Ultrasound scan of pelvic region through rectum	51	51	$220.00	$92.75
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	45	31	$59.00	$19.63
51700 Simple bladder irrigation and/or instillation	25	16	$194.00	$71.12
55700 Biopsy of prostate gland	23	23	$508.00	$241.62
81001 Manual urinalysis test with examination using microscope, automated	21	20	$10.00	$3.84
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	20	20	$140.00	$57.76
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	19	13	$46.00	$20.74
51702 Simple insertion of temporary bladder tube	16	11	$164.00	$61.60
51741 Electronic assessment of bladder emptying	11	11	$18.82	$4.53
74176 Ct scan of abdomen and pelvis without contrast	11	11	$280.55	$114.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	1,485	15	$0.50	$0.12
81003 Automated urinalysis test	776	518	$7.00	$3.01
99213 Established patient office or other outpatient visit, typically 15 minutes	528	404	$168.00	$69.75
51798 Ultrasound measurement of bladder capacity after voiding	219	170	$44.00	$17.98
36415 Insertion of needle into vein for collection of blood sample	201	159	$15.00	$2.94
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	145	145	$380.00	$156.48
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	96	81	$101.00	$41.45
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	90	76	$249.00	$102.98
52000 Diagnostic exam of bladder and urethra using an endoscope	72	66	$477.00	$156.70
81001 Manual urinalysis test with examination using microscope, automated	70	67	$10.00	$4.26
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	51	30	$59.00	$24.04
J0696 Injection, ceftriaxone sodium, per 250 mg	48	12	$3.00	$0.64
76872 Ultrasound scan of pelvic region through rectum	41	40	$220.00	$88.43
55700 Biopsy of prostate gland	19	19	$508.00	$227.20
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	19	19	$140.00	$55.15
74178 Ct scan of abdomen and pelvis before and after contrast	13	13	$588.00	$206.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$250.00	$103.56

Medical Specialties & State Licenses

CMS Verified: 2021-11-01

Urology Primary Specialty

NUCC Taxonomy Code: 208800000X

State License TX D7435

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.

Specialist

NUCC Taxonomy Code: 174400000X

State License TX D7435

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

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

18 Associated Practitioners

Wendy Short , FNP-C

Nurse Practitioner - Family

NPI 1073854733

Family Nurse Practitioner (Certified)

Colleen Hunter-Gaudreau , NP-C

Nurse Practitioner - Family

NPI 1073963153

Nurse Practitioner (Certified)

Holly Kane , PA-C

Physician Assistant - Medical

NPI 1093408981

Physician Assistant (Certified)

Dr. Kashyap Shatagopam , MD

Urology

NPI 1114308467

Doctor of Medicine (M.D.)

Alisa Calvillo , PT

Physical Therapist

NPI 1235703026

Physical Therapist

Ana Gomez-Rubio , PA-C

Physician Assistant

NPI 1285118141

Physician Assistant (Certified)

Career & Practice History Timeline

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

10 Historical Events

📍

Updated Practice Location November 01, 2021

Registered at 1900 SCENIC DR STE 1114, GEORGETOWN, TX 786267724 (Tel: 5122482200)

📍

Updated Business Mailing Address November 01, 2021

Registered at 8240 N MOPAC EXPY STE 100, AUSTIN, TX 787598869 (Tel: 5126871950)

👤

Provider Name / Credentials Updated November 01, 2021

Recorded as JACK LONG, MD

📍

Updated Business Mailing Address October 07, 2020

Registered at 8240 N MOPAC EXPY, STE 100, AUSTIN, TX 787598869 (Tel: 5129305005)

✅

NPI Profile Active April 10, 2012

NPI status registered as active in NPPES database

📍

Updated Practice Location April 10, 2012

Registered at 1900 SCENIC DR, SUITE 3318, GEORGETOWN, TX 786267724 (Tel: 5129305005)

📍

Updated Business Mailing Address April 10, 2012

Registered at 1900 SCENIC DR, SUITE 3318, GEORGETOWN, TX 786267724 (Tel: 5129305005)

👤

Provider Name / Credentials Updated April 10, 2012

Recorded as JACK LONG, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 10, 2012

Specialist (License #D7435 in TX)

🟢

Initial NPI Registration & Enumeration November 02, 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: 1376534917

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: November 02, 2005

Last Update: November 01, 2021

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

8240 N Mopac Expy Ste 100

Austin, TX 787598869

Phone: 5126871950

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.