DR. JONATHAN DAVID BIRNBERG (PH.D.) – Psychologist, NPI 1174674279

DR. JONATHAN DAVID BIRNBERG (PH.D.) is a healthcare provider. based in South portland, Maine. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. PS1192 (ME). The NPI Number for DR. JONATHAN DAVID BIRNBERG (PH.D.) is 1174674279

Main info

Male
Sole Proprietor
26 Years Of Experience
Accepts Medicare Assignment
Name
DR. JONATHAN DAVID BIRNBERG (PH.D.)
NPI
1174674279
Phone
(207) 775-2220
Address
609 MAIN ST
Enumeration Date
15 January 2007
Last Update Date
13 October 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2077752220
Graduation Year
2000 (26 years ago)
PAC ID
4183611858
Professional Enrollment ID
I20080509000531
Address ID
ME041065470SO609XXSTXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience71
Completeness75
Years active:19State licenses:2Digital endpointsOther names

173 CLINICAL PSYCHOLOGIST in ME

Loading map...

Provider Addresses for DR. JONATHAN DAVID BIRNBERG (PH.D.)

  • 609, Main Street, Thornton Heights, South Portland, Cumberland County, Maine, 04106, United States

    SUITE 3

    SOUTH PORTLAND, ME 041065453

    Phone: (207) 775-2220

    Fax: (207) 775-2226

    Type: Location

  • 332, Pool Street, Tattle Corner, Biddeford, York County, Maine, 04005, United States

    BIDDEFORD, ME 040059713

    Phone: (207) 775-2220

    Fax: (207) 775-2226

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2008-05-09

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
I20080509000531IClinical PsychologistMETBD

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 04106)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Does DR. JONATHAN DAVID BIRNBERG (PH.D.) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. JONATHAN DAVID BIRNBERG (PH.D.) uses 1174674279.
Can I rely on DR. JONATHAN DAVID BIRNBERG (PH.D.) being an active provider?
As of the registry snapshot, DR. JONATHAN DAVID BIRNBERG (PH.D.) is marked active.
What is DR. JONATHAN DAVID BIRNBERG (PH.D.)'s primary classification?
Psychologist is the headline specialty for DR. JONATHAN DAVID BIRNBERG (PH.D.) here. Clinical services aligned with this taxonomy classification.
What address line appears for DR. JONATHAN DAVID BIRNBERG (PH.D.)?
DR. JONATHAN DAVID BIRNBERG (PH.D.)'s geographic hint is South Portland, Maine in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.