DR. MICHAEL KORNBERG M.D.
NPI 1174786834
Psychiatry & Neurology - Child & Adolescent Psychiatry in San Diego, CA
NPI Status: Active since July 03, 2008
Contact Information
12625 HIGH BLUFF DR
SUITE 305
SAN DIEGO, CA
ZIP 92130
Phone: (858) 279-1223
Fax: (858) 509-4789
- Individual
- Male
- Psychiatry & Neurology
- Child & Adolescent Psychiatry
- Opted-Out Medicare
About MICHAEL KORNBERG
This page provides the complete NPI Profile along with additional information for Michael Kornberg, a provider established in San Diego, California with a medical specialization in Psychiatry & Neurology, focusing in child & adolescent psychiatry . The healthcare provider is registered in the NPI registry with number 1174786834 assigned on July 2008. The practitioner's primary taxonomy code is 2084P0804X with license number A101909 (CA). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1174786834
- Provider Name
- DR. MICHAEL KORNBERG M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 12625 HIGH BLUFF DR SUITE 305 SAN DIEGO, CA 92130
- Location Phone
- (858) 279-1223
- Location Fax
- (858) 509-4789
- Mailing Address
- 12625 HIGH BLUFF DR SUITE 305 SAN DIEGO, CA 92130
- Mailing Phone
- (858) 279-1223
- Mailing Fax
- (858) 509-4789
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 07-03-2008
- Last Update Date
- 06-16-2010
- Code Navigator
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Michael Kornberg opted out of Medicare effective on 02-10-2022 until 02-10-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychiatry & Neurology Child & Adolescent Psychiatry
- Taxonomy Code
- 2084P0804X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- A101909
- License State
- CA
- Taxonomy Description
- Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 95-1691313 | OTHER (01) | CA | RADY CHILDREN'S HOSPITAL SAN DIEGO, OUTPATIENT PSYCHIATRY |
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 02-10-2022
Opt-Out End Date: 02-10-2026
Eligible to Order and Refer? No
Reviews for DR. MICHAEL KORNBERG M.D.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 7 | 4 | 7 | 8 | 6 | 8 | 3 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 14 | 4 | 14 | 8 | 12 | 8 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 4 + 4 + 1 + 4 + 8 + 1 + 2 + 8 + 6 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1174786834 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1902851900 | LAGASSE YATES, INC Organization | Psychologist (Clinical) | 12625 HIGH BLUFF DR SUITE 206 SAN DIEGO, CA 92130 (858) 793-8768 |
| 1881633618 | DR. RONALD BRADFIELD YATES JR. PH.D. Individual | Psychologist (Clinical) | 12625 HIGH BLUFF DR SUITE 206 SAN DIEGO, CA 92130 (858) 793-1855 |
| 1164461836 | DR. SUSAN LAGASSE PH.D. Individual | Psychologist (Clinical) | 12625 HIGH BLUFF DR SAN DIEGO, CA 92130 (858) 793-8768 |
| 1821030677 | DR. CRAIG WILLIAM CARLSON PH.D. Individual | Psychologist | 12625 HIGH BLUFF DR SUITE 114-C SAN DIEGO, CA 92130 (760) 758-5680 |
| 1740391572 | DR. TRACY RATERMANN PH.D. Individual | Psychologist (Clinical) | 12625 HIGH BLUFF DR SUITE 215 SAN DIEGO, CA 92130 (619) 933-2760 |
| 1255437828 | DR. DARLENE B SWEETLAND PH.D. Individual | Psychologist (Clinical) | 12625 HIGH BLUFF DR SUITE #104 SAN DIEGO, CA 92130 (858) 382-1137 |
| 1508905456 | KAREN IRENE HALL PH.D. Individual | Psychologist (Clinical) | 12625 HIGH BLUFF DR 114 SAN DIEGO, CA 92130 (760) 443-5425 |
| 1871626374 | MS. MICHELLE PIPER LMFT Individual | Marriage & Family Therapist | 12625 HIGH BLUFF DR #316 SAN DIEGO, CA 92130 (858) 455-9716 |
| 1609992262 | DR. DEBORAH CAREN PONTILLO PH.D. Individual | Psychologist (Clinical Child & Adolescent) | 12625 HIGH BLUFF DR SUITE #101 SAN DIEGO, CA 92130 (858) 692-4187 |
| 1083732770 | DR. CARRIE JAFFE PH.D Individual | Psychologist (Clinical) | 12625 HIGH BLUFF DR #101 SAN DIEGO, CA 92130 (858) 208-9689 |
| 1306069984 | MS. JEANNINE JOYCE REEVES MFT Individual | Marriage & Family Therapist | 12625 HIGH BLUFF DR STE. 113 SAN DIEGO, CA 92130 (858) 229-9346 |
| 1902022726 | DR. LEWIS RIBNER PH.D. Individual | Psychologist (Clinical) | 12625 HIGH BLUFF DR SUITE 202 SAN DIEGO, CA 92130 (858) 792-5773 |
| 1891912887 | DANA MARIE FILLMORE PSY.D. Individual | Psychologist (Clinical) | 12625 HIGH BLUFF DR SUITE 104 SAN DIEGO, CA 92130 (858) 755-7844 |
| 1588879027 | MS. LORNA GAIL CHRISTENSEN LCSW Individual | Social Worker (Clinical) | 12625 HIGH BLUFF DR SUITE 316 SAN DIEGO, CA 92130 (858) 453-8111 |
| 1710183306 | JILL SILVERMAN L.C.S.W. Individual | Social Worker (Clinical) | 12625 HIGH BLUFF DR SUITE 215 SAN DIEGO, CA 92130 (858) 793-2400 |
| 1497947204 | DR. AZMAIRA HAMID MAKER PH.D. Individual | Psychologist (Clinical) | 12625 HIGH BLUFF DR SUITE 215 SAN DIEGO, CA 92130 (858) 531-1122 |
| 1922272319 | JULIA J KIEL M.A., CCC/SLP Individual | Speech-Language Pathologist | 12625 HIGH BLUFF DR STE 104 SAN DIEGO, CA 92130 (858) 794-9514 |
| 1578711206 | MR. RANDY MARK HERMAN MFT Individual | Marriage & Family Therapist | 12625 HIGH BLUFF DR SUITE 114 SAN DIEGO, CA 92130 (858) 356-9786 |
| 1023261898 | DR. MARIBEL PERAZA BRADBERRY PH.D. Individual | Psychologist (Clinical) | 12625 HIGH BLUFF DR SUITE 114 SAN DIEGO, CA 92130 (619) 835-9972 |
| 1144461872 | WCS INC. Organization | Speech-Language Pathologist | 12625 HIGH BLUFF DR STE 104 SAN DIEGO, CA 92130 (858) 794-9514 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174786834, enumerated in the NPI registry as an "individual" on July 03, 2008
The provider is located at 12625 High Bluff Dr Suite 305 San Diego, Ca 92130 and the phone number is (858) 279-1223
The provider's speciality is Psychiatry & Neurology with taxonomy code 2084P0804X with a focus in Child & Adolescent Psychiatry
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
No, the provider signed an affidavit on February 10, 2022 to opt-out of the Medicare program. The provider is excluded from the Medicare program until February 10, 2026.
This NPI record was last updated on July 03, 2008. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.