DR. MARK IRA BORNSTEIN (PSYD) – Psychologist, NPI 1518078351
Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,603 CLINICAL PSYCHOLOGIST in IL
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Provider Addresses for DR. MARK IRA BORNSTEIN (PSYD)
46, Cumberland Drive, Lincolnshire, Lake County, Illinois, 60069, United States
LINCOLNSHIRE, IL 60069
Phone: (847) 471-8883
Fax: (773) 751-2250
Type: Mailing
175, Olde Half Day Road, Lincolnshire, Lake County, Illinois, 60069, United States
SUITE 140-2
LINCOLNSHIRE, IL 600693061
Phone: (847) 471-8883
Fax: (773) 751-2250
Type: Location
101 RIVERFRONT BLVD STE 710
BRADENTON, FL 342058812
Phone: (941) 776-4000
Fax: (941) 845-4963
Type: Mailing
725 N 12TH AVE BLDG B
ARCADIA, FL 342668752
Phone: (863) 494-1242
Type: Location
4310 METRO PKWY STE 205
FORT MYERS, FL 339169416
Phone: (239) 690-6906
Type: Mailing
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: 2022-07-01
PECOS data refreshed: 2026-06-15
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220701000812 | I | Clinical Psychologist | FL | TBD |
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.
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 60069)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| - | FL | |
| - | TN | |
| Nurse Practitioner, Clinical Psychologist | FL | |
| Clinical Psychologist | FL | |
| P O D I A T R Y | FL | |
| Cardiovascular Disease (Cardiology) | FL | |
| Nurse Practitioner | FL | |
| Clinical Psychologist | FL | |
| P O D I A T R Y | FL |
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