Jacksonville Psychiatric Association Inc - Medicare Mental Health Clinic in Jacksonville, FL

Jacksonville Psychiatric Association Inc is a medicare enrolled mental health clinic (Psychiatry & Neurology - Psychiatry) in Jacksonville, Florida. The current practice location for Jacksonville Psychiatric Association Inc is 10175 Fortune Pkwy, Suite 104, Jacksonville, Florida. For appointments, you can reach them via phone at (904) 379-8748. The mailing address for Jacksonville Psychiatric Association Inc is 10175 Fortune Pkwy, Suite 104, Jacksonville, Florida and phone number is (973) 901-0394.

Jacksonville Psychiatric Association Inc is licensed to practice in Florida (license number ME112178). The clinic also participates in the medicare program and its NPI number is 1205261765. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (904) 379-8748.

Contact Information

Jacksonville Psychiatric Association Inc
10175 Fortune Pkwy
Suite 104
Jacksonville
FL 32256-6746
(904) 379-8748
(904) 379-8796

Mental Health Clinic Profile

Full NameJacksonville Psychiatric Association Inc
SpecialityPsychiatry & Neurology
Location10175 Fortune Pkwy, Jacksonville, Florida
Authorized Official Name and PositionImtiaz Rasul (OWNER)
Authorized Official Contact9739010394
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jacksonville Psychiatric Association Inc
10175 Fortune Pkwy
Suite 104
Jacksonville
FL 32256-6746

Ph: (973) 901-0394
Jacksonville Psychiatric Association Inc
10175 Fortune Pkwy
Suite 104
Jacksonville
FL 32256-6746

Ph: (904) 379-8748

NPI Details:

NPI Number1205261765
Provider Enumeration Date09/03/2013
Last Update Date11/07/2014

Medicare PECOS Information:

Medicare PECOS PAC ID2668607722
Medicare Enrollment IDO20131105001673

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Medical Identifiers

Medical identifiers for Jacksonville Psychiatric Association Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1205261765NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2084P0800XPsychiatry & Neurology - Psychiatry ME112178 (Florida)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Jacksonville Psychiatric Association Inc acts as a billing entity for following providers:
Provider NameImtiaz Rasul
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1205071719
PECOS PAC ID: 4385775584
Enrollment ID: I20130111000326

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