CHRISTIAN JACOB PEMBERTON (MD) – Psychiatry Physician, NPI 1639705619

CHRISTIAN JACOB PEMBERTON (MD) is a healthcare provider. based in Cincinnati, Ohio. specializing in PSYCHIATRY. They hold the professional credentials MD. They hold a License No. 58963 (KY). The NPI Number for CHRISTIAN JACOB PEMBERTON (MD) is 1639705619

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
CHRISTIAN JACOB PEMBERTON (MD)
NPI
1639705619
Phone
(513) 558-5190
Address
260 STETSON ST STE 3200
Enumeration Date
21 March 2020
Last Update Date
26 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8593015901
Graduation Year
2020 (6 years ago)
PAC ID
2860932878
Group Practice PAC ID
2163326240
Professional Enrollment ID
I20240905000989
Address ID
KY410712570NE1400XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:6State licenses:1Digital endpointsOther names

1,247 PSYCHIATRY in OH

Provider Addresses for CHRISTIAN JACOB PEMBERTON (MD)

  • 260 STETSON ST STE 3200

    CINCINNATI, OH 452192472

    Phone: (513) 558-5190

    Fax: (513) 558-3477

    Type: Mailing

  • PO BOX 635283

    CINCINNATI, OH 452635283

    Phone: (859) 301-5901

    Fax: (859) 301-5940

    Type: Mailing

  • 1400 GRAND AVE

    NEWPORT, KY 410712570

    Phone: (859) 301-5901

    Fax: (859) 301-5940

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $491.

Total Amount is formed as General ($491) + Research ($0) + Ownership ($0) = $491.

Last reported payment date: 2024-11-27 • Largest payer in this snapshot: ABBVIE INC. ($139).

Total Amount

$491

General + Research + Ownership

Payments

5

Total payment records

General Amount

$491

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-27

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2024-09-05

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
I20240905000989IPsychiatryKYTBD

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 45219)

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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: 2163326240View full group profile
NameSpecialtyState
Internal MedicineKY
Family PracticeOH
H O S P I T A L I S TOH
Family PracticeKY
Family PracticeOH
G A S T R O E N T E R O L O G YKY
-KY
Family PracticeOH
-FL
Nurse PractitionerKY

Reviews

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Frequently asked questions

What NPI should I save for CHRISTIAN JACOB PEMBERTON (MD)?
Save NPI 1639705619 if you need a stable reference for CHRISTIAN JACOB PEMBERTON (MD).
Is CHRISTIAN JACOB PEMBERTON (MD)'s NPI currently valid?
The extract we use shows CHRISTIAN JACOB PEMBERTON (MD) as active.
What does CHRISTIAN JACOB PEMBERTON (MD) treat or focus on?
Patients typically see CHRISTIAN JACOB PEMBERTON (MD) under the specialty Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Does CHRISTIAN JACOB PEMBERTON (MD) practice in Ohio?
You will see Cincinnati, Ohio on file for CHRISTIAN JACOB PEMBERTON (MD) alongside any extra practice locations.
How can I contact CHRISTIAN JACOB PEMBERTON (MD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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