Longevity Functional Wellness - Medicare Dietitian in Ponte Vedra Beach, FL

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Longevity Functional Wellness is a medicare enrolled "Dietitian, Registered" provider in Ponte Vedra Beach, Florida. Their current practice location is 500 Canal Rd, Ponte Vedra Beach, Florida. You can reach out to their office (for appointments etc.) via phone at (904) 535-6901.

Longevity Functional Wellness is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Longevity Functional Wellness is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1629725312.

Contact Information

Longevity Functional Wellness
500 Canal Rd,
Ponte Vedra Beach, FL 32082-4300
(904) 535-6901
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameLongevity Functional Wellness
TypeFacility
SpecialityDietitian, Registered
Location500 Canal Rd, Ponte Vedra Beach, Florida
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1629725312
  • Provider Enumeration Date: 03/03/2022
  • Last Update Date: 04/05/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 6608237342
  • Enrollment ID: O20230728000198

Medical Identifiers

Medical identifiers for Longevity Functional Wellness such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1629725312NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
133V00000XDietitian, Registered (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Longevity Functional Wellness acts as a billing entity for following providers:
Provider NameTracey O'neill
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1356096887
PECOS PAC ID: 7517328263
Enrollment ID: I20230728000226

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Longevity Functional Wellness is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Longevity Functional Wellness
500 Canal Rd,
Ponte Vedra Beach, FL 32082-4300

Ph: (904) 535-6901		Longevity Functional Wellness
500 Canal Rd,
Ponte Vedra Beach, FL 32082-4300

Ph: (904) 535-6901

Reviews and Comments


Dietitian, Registered in Ponte Vedra Beach, FL

Greenlyfe Nutrition, Llc
Dietitian
Medicare: Not Enrolled in Medicare
Practice Location: 312 Osprey Nest Ct, Ponte Vedra Beach, FL 32082
Phone: 508-963-8537    
Laura Vazzo Mcdevitt, M.ED.,R.D.,LD/N
Dietitian
Medicare: Not Enrolled in Medicare
Practice Location: 428 Clearwater Dr, Ponte Vedra Beach, FL 32082
Phone: 904-469-1717    
Tracey O'neill, CNS, LDN
Dietitian
Medicare: Medicare Enrolled
Practice Location: 500 Canal Rd, Ponte Vedra Beach, FL 32082
Phone: 904-535-6901    
Bariwell Lifestyle, Llc
Dietitian
Medicare: Medicare Enrolled
Practice Location: 782 Nocatee Village Dr, Ponte Vedra Beach, FL 32081
Phone: 954-829-8822    
Carolyn Irene Dewane, RD,LD
Dietitian
Medicare: Not Enrolled in Medicare
Practice Location: 253 Seamist Ct, Ponte Vedra Beach, FL 32082
Phone: 904-610-1640    
Blaire Murphy,
Dietitian
Medicare: Not Enrolled in Medicare
Practice Location: 705 Boardwalk Dr Unit 434, Ponte Vedra Beach, FL 32082
Phone: 904-806-8553    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.