Nicholas Jk Breitborde, PHD in Columbus, OH - Medicare Psychologist Provider

Nicholas Jk Breitborde, PHD is a medicare enrolled "Psychologist - Family" provider in Columbus, Ohio. His current practice location is 1670 Upham Dr, Ste 130, Columbus, Ohio. You can reach out to his office (for appointments etc.) via phone at (614) 293-8234.

Nicholas Jk Breitborde is licensed to practice in Ohio (license number 7267) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1225363849.

Contact Information

	Nicholas Jk Breitborde, PHD
	1670 Upham Dr, Ste 130, Columbus, OH 43210-1250
	(614) 293-8234
	(614) 293-8552

Map and Direction

Healthcare Provider's Profile

Full Name	Nicholas Jk Breitborde
Gender	Male
Speciality	Psychologist - Family
Location	1670 Upham Dr, Columbus, Ohio
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1225363849
Provider Enumeration Date: 10/15/2009
Last Update Date: 12/03/2024

Medicare PECOS Information:

PECOS PAC ID: 2668510082
Enrollment ID: I20150527002749

Medical Identifiers

Medical identifiers for Nicholas Jk Breitborde such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1225363849	NPI	-	NPPES
0132375	Medicaid	OH

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TF0000X	Psychologist - Family	4063 (Arizona)	Secondary
103TF0000X	Psychologist - Family	7267 (Ohio)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Nicholas Jk Breitborde allows following entities to bill medicare on his behalf.

Entity Name	Osu Psychiatry Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1194773317 PECOS PAC ID: 0749272714 Enrollment ID: O20040331000566

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicholas Jk Breitborde is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Nicholas Jk Breitborde, PHD 700 Ackerman Rd Ste 2120, Columbus, OH 43202-1559 Ph: (614) 293-8234	Nicholas Jk Breitborde, PHD 1670 Upham Dr, Ste 130, Columbus, OH 43210-1250 Ph: (614) 293-8234

Reviews and Comments

Psychologist in Columbus, OH

Dr. Justin C Baker, PHD, ABPP Psychologist Medicare: Medicare Enrolled Practice Location: 3650 Olentangy River Rd Ste 310, Columbus, OH 43214 Phone: 614-257-2069
Liesel Parsons, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 737 E Hudson St, Columbus, OH 43211 Phone: 614-365-5220
Kaitlyn Mosher, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 700 Childrens Dr, Columbus, OH 43205 Phone: 614-722-4700 Fax: 614-722-4718
Megan M Perry, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 700 Childrens Dr, Columbus, OH 43205 Phone: 614-722-4700 Fax: 614-722-4718
Sabrina Sykes, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 1800 Zollinger Rd Fl 5, Columbus, OH 43221 Phone: 614-293-9600 Fax: 614-293-1456
Lisa Marie Foulk, PSY.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 2200 W Broad St, Columbus, OH 43223 Phone: 614-752-0333
Wesley Howard Sylvia, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1800 Harmon Ave, Columbus, OH 43223 Phone: 614-445-8600

Nicholas Jk Breitborde, PHD - Medicare Psychologist in Columbus, OH