Individual provider Active NPI

Jason Gregory Lulejian, D.O.

  • Psychiatry Physician
  • Jacksonville, FL
National Provider Identifier
1245643048
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
OS18853 Issued in FL
Practice address
820 Prudential Dr Ste 510
Jacksonville, FL 32207-8207
Phone
(904) 376-3800
NPI assigned
Jun 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X OS18853 FL
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 297758 NY
Psychiatry Physician 2084P0800X 1016675 MA
Psychiatry Physician 2084P0800X OS020665 PA
Psychiatry Physician 2084P0800X DO217288 OR
Psychiatry Physician 2084P0800X 032.0134177 VT
Psychiatry Physician 2084P0800X 036166039 IL
Psychiatry Physician 2084P0800X 297758 NY
Psychiatry Physician 2084P0800X O-1867 ID
Psychiatry Physician 2084P0800X 25MB11880300 NJ
Psychiatry Physician 2084P0800X OP61439144 WA
Psychiatry Physician 2084P0800X DR.0073625 CO
Psychiatry Physician 2084P0800X OS18853 FL Primary

Addresses

Primary practice location

820 Prudential Dr Ste 510
Jacksonville, FL 32207-8207

Mailing address

PO Box 748519
Atlanta, GA 30374-8519
Phone (904) 376-3800

Other practice location 1

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 124-5643

Other practice location 2

9995 Gate Pkwy N
Jacksonville, FL 32246-4481
Phone (904) 981-1616

Other practice location 3

800 Irving Ave
Syracuse, NY 13210-2716
Phone (315) 425-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA, FL, NJ, WA, IL, MA, VT, CO9 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 9

Enrollment IDStateProvider typePAC IDDetails
I20190517000237 NY Practitioner - Psychiatry 8426395062 Reassigns benefits to 4 organizations
I20200807002196 PA Practitioner - Psychiatry 8426395062 Reassigns benefits to 1 organization
I20221003000986 FL Practitioner - Psychiatry 8426395062 Reassigns benefits to 2 organizations
I20230607000602 NJ Practitioner - Psychiatry 8426395062 Reassigns benefits to 2 organizations
I20230721001860 WA Practitioner - Psychiatry 8426395062 Reassigns benefits to 1 organization
I20230817003953 IL Practitioner - Psychiatry 8426395062 Reassigns benefits to 1 organization
I20230927003041 MA Practitioner - Psychiatry 8426395062 Reassigns benefits to 1 organization
I20240312002978 VT Practitioner - Psychiatry 8426395062 Reassigns benefits to 1 organization
I20241026000131 CO Practitioner - Psychiatry 8426395062 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
297758NYMDAddiction Medicine (Psychiatry & Neurology) Physician
DR.0073625COMDPsychiatry Physician
OS18853FLMDPsychiatry Physician
O-1867IDMDPsychiatry Physician
036166039ILMDPsychiatry Physician
1016675MAMDPsychiatry Physician
25MB11880300NJMDPsychiatry Physician
DO217288ORMDPsychiatry Physician
OS020665PAMDPsychiatry Physician
032.0134177VTMDPsychiatry Physician
OP61439144WAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Valera Medical, P.C. Psychiatry CurrentSince Nov 1, 2022 Accepting new patients
Albany Medical College CurrentSince Sep 8, 2020 Accepting new patients
Pinnacle Health Medical Services CurrentSince Mar 17, 2021 Accepting new patients
Personal Recovery Network LLC Psychiatry CurrentSince Oct 17, 2022 Accepting new patients
Teladoc Health Medical Group, P.a. Psychiatry Current Accepting new patients
Big Leap Medical Group PA Psychiatry CurrentSince Jul 1, 2024 Accepting new patients
Psychiatry Faculty Practice, Inc. Psychiatry CurrentSince Jul 15, 2019 Accepting new patients
Albany Medical College Psychiatry CurrentSince Sep 8, 2020 Accepting new patients
Valera Medical, P.a. Psychiatry CurrentSince May 22, 2023 Accepting new patients
Albany Medical College CurrentSince Sep 8, 2020 Accepting new patients
Pinnacle Health Medical Services Current Accepting new patients
Multicare Health System CurrentSince Aug 18, 2023 Accepting new patients
Multicare Health System Psychiatry CurrentSince Aug 18, 2023 Accepting new patients
Pinnacle Health Medical Services CurrentSince Mar 17, 2021 Accepting new patients
Valera Medical, P.a. Psychiatry CurrentSince Nov 1, 2022 Accepting new patients
Southern Baptist Hospital of Florida Inc Past Accepting new patients

Locations

720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589

14645 NW 77th Ave
Ste 101
Miami Lakes, FL 33014
Phone (786) 785-9033

1800 Pembrook Dr
Ste 300
Orlando, FL 32810
Phone (321) 200-4489

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

980 N Michigan Ave
Ste 1400
Chicago, IL 60611
Phone (312) 214-3605

225 Cedar Hill St
Ste 200
Marlborough, MA 01752
Phone (617) 863-9090

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

5170 US Highway 9
Howell, NJ 07731
Phone (332) 334-1511

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

134 N 4th St
Brooklyn, NY 11249

134 N 4th St
Ofc 2168
Brooklyn, NY 11249

139 Centre St
Ste 824
New York, NY 10013
Phone (646) 450-7751

169 Madison Ave
Ste 2828
New York, NY 10016
Phone (332) 330-4076

295 Madison Ave
Rm 407
New York, NY 10017
Phone (332) 334-1511

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

713 Harrison St
Bldg 3
Syracuse, NY 13210
Phone (315) 464-3265

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

205 S Front St
Fl 5
Harrisburg, PA 17104
Phone (717) 231-8360

1 Lawson Ln
Ste 200D
Burlington, VT 05401
Phone (802) 236-6742

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

Interoperability endpoints

  • Direct secure messaging: lulejiaj@hiemail.healtheconnections.org
  • Direct secure messaging: jasonlulejian@tdh.allscriptsdirect.net

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1245643048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748519",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748519",
            "telephone_number": "904-376-3800",
            "fax_number": "904-376-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 PRUDENTIAL DR STE 510",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078207",
            "telephone_number": "904-376-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 E Adams St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132102306",
            "country_code": "US",
            "telephone_number": "315-124-5643",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9995 Gate Pkwy N",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322464481",
            "country_code": "US",
            "telephone_number": "904-981-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Irving Ave",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132102716",
            "country_code": "US",
            "telephone_number": "315-425-4400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LULEJIAN",
        "first_name": "JASON",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-09",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "FL",
            "license": "OS18853",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NY",
            "license": "297758",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "1016675",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "OS020665",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "DO217288",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "032.0134177",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036166039",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "297758",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ID",
            "license": "O-1867",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MB11880300",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "OP61439144",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0073625",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "OS18853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.