Individual provider Active NPI

Brian Gerard Celso, PHD.

  • Psychologist
  • Jacksonville, FL
National Provider Identifier
1235102732
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY6042 Issued in FL
Practice address
4114 Herschel St Ste 110
Jacksonville, FL 32210-2200
Phone
(904) 210-1130
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY6042 FL Primary

Addresses

Primary practice location

4114 Herschel St Ste 110
Jacksonville, FL 32210-2200

Mailing address

4114 Herschel St Ste 110
Jacksonville, FL 32210-2200
Phone (904) 210-1130

Other identifiers 2

IdentifierTypeStateIssuer
001905600MedicaidFL
268322647AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080617000693 FL Practitioner - Clinical Psychologist 8729159827 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Apr 4, 2008 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Apr 4, 2008 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Sep 20, 2019 Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

580 W 8th St
Jacksonville, FL 32209
Phone (904) 244-3960

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1235102732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 HERSCHEL ST STE 110",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102200",
            "telephone_number": "904-210-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4114 HERSCHEL ST STE 110",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102200",
            "telephone_number": "904-210-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CELSO",
        "first_name": "BRIAN",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "PHD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001905600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268322647A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.