Elliott Richelson, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

117284 Issued in FL

Practice address

1300 Marsh Landing Pkwy Ste 112
Jacksonville Beach, FL 32250-2407

Phone

(904) 456-0002

Fax

(904) 373-0894

NPI assigned

Oct 22, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 8

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL, MN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Psychiatry

Education

Johns Hopkins University School of Medicine, 1969

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elliott.richelson.1@28621.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/24776/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Optum Behavioral Care of North Carolina, PC

  • Counseling Psychologist
  • Sarasota, FL
  • NPI 1033984448
  Medicare reassignment NPD
• Optum Behavioral Care of Colorado, P.C.

  • Clinical Psychologist
  • Baxter, MN
  • NPI 1124898556
  Medicare reassignment
• Evolve LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Appleton, WI
  • NPI 1821541137
  NPD (past) Authorized official
• Optum Behavioral Care of Colorado, P.C.

  • Clinical Psychologist
  • Minneapolis, MN
  • NPI 1053181487
  NPD
• Optum Behavioral Care of Colorado, P.C.

  • Clinical Social Worker
  • De Pere, WI
  • NPI 1396622494
  NPD
• Heron Ridge Associates PLC

  • Counselor
  • Brighton, MI
  • NPI 1144810946
  NPD (past)
• Optum Behavioral Care of North Carolina, P.C.

  • Clinical Social Worker
  • Little Rock, AR
  • NPI 1053298711
  NPD (past)
• Refresh in-Home Counseling LLC

  • Clinical Social Worker
  • Antioch, IL
  • NPI 1609365519
  NPD (past)
• Spring Behavioral Health of New Jersey LLC

  • Clinical Social Worker
  • Cherry Hill, NJ
  • NPI 1003327958
  NPD (past)
• Springfield Psychological PC

  • Mental Health Counselor
  • Springfield, PA
  • NPI 1295705317
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1124018056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MARSH LANDING PKWY STE 112",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322502407",
            "telephone_number": "904-456-0002",
            "fax_number": "904-373-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MARSH LANDING PKWY STE 112",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322502407",
            "telephone_number": "904-456-0002",
            "fax_number": "904-373-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHELSON",
        "first_name": "ELLIOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-22",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "61847",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G170998",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "74291-20",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "285944",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NH",
            "license": "EL10717",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "264936",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA10930300",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "117284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "700006036",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD",
            "identifier": "09949",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela M Reynolds, OTR
• Steven Lloyd Rhodes, D.C.
• Stephanie Lynn Ribeiro, DPT
• Nicole Annmarie Riccardi, CRNA
• Nicole Elizabeth Rice, MS, OTR/L
• Rebekah M. Richmond, MD
• Rick K. Harrison, D.M.D., PA
• Sherry Rickard, PT
• Michael William Riesmeyer, LMT
• Ripple Effects Therapy, LLC

• Psychiatry Physician in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.