DR. THOMAS ARTHUR BREITENBUCHER (PH.D., L.P.) – Clinical Psychologist, NPI 1699846154

DR. THOMAS ARTHUR BREITENBUCHER (PH.D., L.P.) is a healthcare provider. based in Brooklyn center, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D., L.P.. They hold a License No. LP2794 (MN). The NPI Number for DR. THOMAS ARTHUR BREITENBUCHER (PH.D., L.P.) is 1699846154

Main info

Male
32 Years Of Experience
Name
DR. THOMAS ARTHUR BREITENBUCHER (PH.D., L.P.)
NPI
1699846154
Phone
(763) 531-0566
Address
6120 EARLE BROWN DR
Enumeration Date
13 November 2006
Last Update Date
17 November 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7635310566106
Graduation Year
1994 (32 years ago)
PAC ID
9638350465
Group Practice PAC ID
3870545668
Professional Enrollment ID
I20110225000638
Address ID
MN553163595CH11165NXXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,110 CLINICAL PSYCHOLOGIST in MN

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Provider Addresses for DR. THOMAS ARTHUR BREITENBUCHER (PH.D., L.P.)

  • 6120, Earle Brown Drive, Brooklyn Center, Hennepin County, Minnesota, 55430, United States

    SUITE 520

    BROOKLYN CENTER, MN 554302123

    Phone: (763) 531-0566

    Fax: (763) 531-0602

    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: 2011-02-25

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
I20110225000638IClinical PsychologistMNTBD

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 55430)

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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: 3870545668View full group profile
NameSpecialtyState
Clinical PsychologistMN
Clinical PsychologistMN
Marriage And Family TherapistMN
-MN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

How do I look up DR. THOMAS ARTHUR BREITENBUCHER (PH.D., L.P.) by NPI?
Use NPI 1699846154 when you need to reference DR. THOMAS ARTHUR BREITENBUCHER (PH.D., L.P.) in forms, claims, or directories.
Does this profile mean DR. THOMAS ARTHUR BREITENBUCHER (PH.D., L.P.) is currently active?
Yes — DR. THOMAS ARTHUR BREITENBUCHER (PH.D., L.P.) appears active in the national provider directory.
Does DR. THOMAS ARTHUR BREITENBUCHER (PH.D., L.P.) list a primary specialty?
If you are matching referrals, note Clinical Psychologist for DR. THOMAS ARTHUR BREITENBUCHER (PH.D., L.P.). Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. THOMAS ARTHUR BREITENBUCHER (PH.D., L.P.)?
The page summarizes Brooklyn Center, Minnesota for DR. THOMAS ARTHUR BREITENBUCHER (PH.D., L.P.); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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