Douglas J Mason, PSYD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PY6497 Issued in FL

Practice address

26540 Ace Ave Ste E-106
Leesburg, FL 34748-8279

Phone

(352) 530-2317

Fax

(352) 530-2180

NPI assigned

Jun 1, 2005

Last updated

Feb 20, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

74.56 of 100Reported as individual

Quality

45

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• The Memory Doctor, LLC

  • Clinical Neuropsychologist
  • Leesburg, FL
  • NPI 1265434534
  Medicare reassignment NPD

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1750383006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26540 ACE AVE STE E-106",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347488279",
            "telephone_number": "352-530-2170",
            "fax_number": "352-530-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26540 ACE AVE STE E-106",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347488279",
            "telephone_number": "352-530-2317",
            "fax_number": "352-530-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "DOUGLAS",
        "middle_name": "J",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY6497",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6497",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "SW4261",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "54884",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Marts
• Marty R Leggett OD PA
• Brijesh Suresh Maru, BPHARM,MS
• Isabella C Marulanda, LMHC
• Mary Ann Tesalona MD Corp
• Massage and Wellness Care
• George M Mathew, M.D.
• Jencymol Mathew, APRN, PMHNP
• Lourdes M Mathew, MD
• Melissa Matias

• Clinical Neuropsychologist in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.