ELITE PSYCHIATRY SPECIALIST – Psychiatric/Mental Health Nurse Practitioner, NPI 1326775016

ELITE PSYCHIATRY SPECIALIST is a healthcare provider. based in Saint johns, Florida. specializing in Psychiatric/Mental Health Nurse Practitioner. The NPI Number for ELITE PSYCHIATRY SPECIALIST is 1326775016

Main info

Organization
Name
ELITE PSYCHIATRY SPECIALIST
NPI
1326775016
Phone
(812) 870-8683
Address
88 LOCHNAGAR MOUNTAIN DR
Authorized Official
MR. BRIAN CLUKIE ADMINISTRATOR
Enumeration Date
3 August 2022
Last Update Date
24 October 2023

Contacts

Secure Messaging
sbourass@epicbh.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience21
Completeness85
Years active:3State licenses:0Other namesUpdated within 12 months

Provider Addresses for ELITE PSYCHIATRY SPECIALIST

  • 88 LOCHNAGAR MOUNTAIN DR

    SAINT JOHNS, FL 322596672

    Phone: (812) 870-8683

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-08-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20230803002395OClinic/Group PracticeFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32259)

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Reviews

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Frequently asked questions

Does ELITE PSYCHIATRY SPECIALIST have a public NPI I can cite?
Public records show ELITE PSYCHIATRY SPECIALIST under NPI 1326775016.
Is ELITE PSYCHIATRY SPECIALIST currently accepting referrals based on NPI status?
Registry metadata lists ELITE PSYCHIATRY SPECIALIST as active.
How should patients interpret ELITE PSYCHIATRY SPECIALIST's specialty?
The extract shows Psychiatric/Mental Health Nurse Practitioner for ELITE PSYCHIATRY SPECIALIST. Clinical services aligned with this taxonomy classification.
Can patients visit ELITE PSYCHIATRY SPECIALIST in Saint Johns, Florida?
For routing, start with Saint Johns, Florida for ELITE PSYCHIATRY SPECIALIST, then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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