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JAMES DERISSE
NPI 1780295170
Counselor - Mental Health in Jacksonville, FL

Active since August 11, 2020PECOS Enrolled
2700 UNIVERSITY BLVD W BLDG B, JACKSONVILLE, FL 32217(904) 638-9767 Get Directions Write a Review

NPPES record last updated: April 25, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 25, 2024, Aug 18, 2020, Aug 11, 2020 (3 updates tracked since 2020).

About James Derisse NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAMES DERISSE (NPI 1780295170) is an individual mental health provider in Jacksonville, Florida, licensed in Florida (22327) and active in the NPI registry since August 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780295170
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameJAMES DERISSE
Location Address2700 UNIVERSITY BLVD W BLDG BJacksonville, FL 32217-2147
Mailing Address159 Silver Creek PlSaint Augustine, FL 32095-9003 · (904) 386-4253
Phone(904) 638-9767
Sole ProprietorYes
Enumeration DateAugust 11, 2020
Last NPPES UpdateApril 25, 20243 updates tracked since enumeration
NPPES CertifiedApril 25, 2024
✔ NPI 1780295170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Licenses✔ Licensed in FL · 22327✔ Licensed in TX · 84360
2700 UNIVERSITY BLVD W BLDG B, Jacksonville, FL 32217
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Oscar Health Maintenance Organization of Florida and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

James Derisse is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHERINE KENDIG MARTIN M.ED.
Rehabilitation Counselor
2700 UNIVERSITY BLVD W BLDG B
JACKSONVILLE, FL 32217
Duval County (904) 674-6400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is James Derisse's NPI number?

The NPI number for James Derisse is 1780295170. It was assigned to this individual provider in the NPPES registry on August 11, 2020.

Where is James Derisse located?

James Derisse practices at 2700 University Blvd W Bldg B, Jacksonville, FL 32217. The listed phone number is (904) 638-9767.

What is James Derisse's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is James Derisse enrolled in Medicare?

Yes. James Derisse is registered in the Medicare PECOS enrollment system.

What insurance does James Derisse accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Oscar Health Maintenance Organization of Florida and UnitedHealthcare list James Derisse as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for James Derisse was last updated on April 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.