KATELYN PENNA BERUBE (M.S. CCC-SLP) – Speech-Language Pathologist, NPI 1093002552

KATELYN PENNA BERUBE (M.S. CCC-SLP) is a healthcare provider. based in Portland, Maine. specializing in Speech-Language Pathologist. They hold the professional credentials M.S. CCC-SLP. They hold a License No. SP2167 (ME). The NPI Number for KATELYN PENNA BERUBE (M.S. CCC-SLP) is 1093002552

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
KATELYN PENNA BERUBE (M.S. CCC-SLP)
NPI
1093002552
Phone
(207) 797-8255
Address
222 AUBURN ST
Enumeration Date
6 July 2011
Last Update Date
3 January 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2077978255
Graduation Year
2011 (15 years ago)
PAC ID
6305086711
Group Practice PAC ID
4284780156
Professional Enrollment ID
I20130709000022
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

Provider Addresses for KATELYN PENNA BERUBE (M.S. CCC-SLP)

  • 222 AUBURN ST

    SUITE 1G

    PORTLAND, ME 041036002

    Phone: (207) 797-8255

    Fax: (207) 797-5560

    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: 2013-07-09

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
I20130709000022IQualified Speech Language PathologistMETBD

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 04103)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4284780156View full group profile
NameSpecialtyState
Qualified Speech Language PathologistME
Qualified Speech Language PathologistME
Qualified AudiologistME
-ME
Qualified Speech Language PathologistME

Reviews

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Frequently asked questions

Can I verify KATELYN PENNA BERUBE (M.S. CCC-SLP) with an NPI only?
You can start verification with NPI 1093002552 for KATELYN PENNA BERUBE (M.S. CCC-SLP), then check state licensing separately.
Does CMS list KATELYN PENNA BERUBE (M.S. CCC-SLP) as active?
Yes — KATELYN PENNA BERUBE (M.S. CCC-SLP) is active in the NPI listing used on this page.
What is KATELYN PENNA BERUBE (M.S. CCC-SLP)'s primary classification?
Speech-Language Pathologist is the headline specialty for KATELYN PENNA BERUBE (M.S. CCC-SLP) here. Clinical services aligned with this taxonomy classification.
Where is KATELYN PENNA BERUBE (M.S. CCC-SLP) based?
KATELYN PENNA BERUBE (M.S. CCC-SLP) is tied to Portland, Maine in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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