Jonathan David Birnberg, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS1192 Issued in ME

Practice address

609 Main St
Suite 3
South Portland, ME 04106-5453

Phone

(207) 775-2220

Fax

(207) 775-2226

NPI assigned

Jan 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in ME

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)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1174674279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 POOL ST",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059713",
            "telephone_number": "207-775-2220",
            "fax_number": "207-775-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 MAIN ST",
            "address_2": "SUITE 3",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041065453",
            "telephone_number": "207-775-2220",
            "fax_number": "207-775-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRNBERG",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ME",
            "license": "PS1192",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "8077",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MASS.",
            "identifier": "W06273",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0005266",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "808393000",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Riley Mae Billings
• Angela Bilodeau, PT
• Edward John Bilotti, MD
• Ann Binder, M.S., CCC-SLP
• Ralph L Birgfeld
• Bishop Health, LLC
• Linda L Bishop
• Lauryn Marie Bissonnette, LCPC
• Donald E Bittermann, M.D.
• Clelia Keza Bizumuremyi

• Psychologist in South Portland, ME
• Providers in South Portland, ME by specialty
• Psychologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.