Ajasha Maxine Long, PHD in Jacksonville, FL - Medicare Psychologist Provider

Ajasha Maxine Long, PHD is a medicare enrolled "Psychologist" provider in Jacksonville, Florida. Her current practice location is 14540 Old Saint Augustine Rd Ste 2591, Jacksonville, Florida. You can reach out to her office (for appointments etc.) via phone at (904) 376-3800.

Ajasha Maxine Long is licensed to practice in Florida (license number PY12271) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1609495282.

Contact Information

	Ajasha Maxine Long, PHD
	14540 Old Saint Augustine Rd Ste 2591, Jacksonville, FL 32258-7420
	(904) 376-3800
	(904) 390-7405

Map and Direction

Healthcare Provider's Profile

Full Name	Ajasha Maxine Long
Gender	Female
Speciality	Psychologist
Location	14540 Old Saint Augustine Rd Ste 2591, Jacksonville, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1609495282
Provider Enumeration Date: 04/13/2020
Last Update Date: 06/03/2024

Medicare PECOS Information:

PECOS PAC ID: 7416337514
Enrollment ID: I20220707001230

Medical Identifiers

Medical identifiers for Ajasha Maxine Long such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1609495282	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC1900X	Psychologist - Counseling	P.08309 (Ohio)	Secondary
103T00000X	Psychologist	PY12271 (Florida)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ajasha Maxine Long allows following entities to bill medicare on her behalf.

Entity Name	The Metrohealth System
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053353896 PECOS PAC ID: 8628982949 Enrollment ID: O20031119000355

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. Ajasha Maxine Long 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 Address	Practice Location Address
Ajasha Maxine Long, PHD 2500 Metrohealth Dr, Cleveland, OH 44109-1900 Ph: (314) 780-8699	Ajasha Maxine Long, PHD 14540 Old Saint Augustine Rd Ste 2591, Jacksonville, FL 32258-7420 Ph: (904) 376-3800

Reviews and Comments

Psychologist in Jacksonville, FL

Dr. Purnima Kumar, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 5251 Emerson St, Jacksonville, FL 32207 Phone: 904-399-0324 Fax: 904-399-0420
Rebecca Marie Tuttle, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1746 Tiffany Pines Cir W, Jacksonville, FL 32225 Phone: 305-586-6044
Dr. Marisa Victoria Byles, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 12443 San Jose Blvd Ste 202, Jacksonville, FL 32223 Phone: 904-515-3503
Antionette Jarshawn Miller-maultsby, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4401 Will Scarlet Rd, Jacksonville, FL 32208 Phone: 904-352-0066
Dr. Brittany Cannon, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 6816 Southpoint Pkwy Ste 202, Jacksonville, FL 32216 Phone: 904-419-7792
Rachel Suzanne Wasson, PHD Psychologist Medicare: Medicare Enrolled Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000
Dr. Tanis Jill Ferman, PH.D Psychologist Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000

Ajasha Maxine Long, PHD - Medicare Psychologist in Jacksonville, FL