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JASON R. KORNBERG M.D.
NPI 1073685764
Psychiatry & Neurology - Forensic Psychiatry in La Jolla, CA

Active since November 15, 2006PECOS EnrolledAccepts Medicare Assignment
3252 HOLIDAY CT STE 205, LA JOLLA, CA 92037(858) 677-9222 Get Directions Write a Review

NPPES record last updated: March 12, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 12, 2026, May 17, 2023, Apr 13, 2023 (3 updates tracked since 2023).

About Jason R. Kornberg M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JASON R. KORNBERG M.D. (NPI 1073685764) is an individual forensic psychiatry provider in La Jolla, California, licensed in California (A79691) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS and is a graduate of New York University School Of Medicine (2000).

NPPES Registry Identity

NPI1073685764
Entity TypeIndividualMale
Primary Taxonomy2084F0202X
Provider Legal NameJASON R. KORNBERGCredential: M.D.
Location Address3252 HOLIDAY CT STE 205La Jolla, CA 92037-1808
Mailing AddressPo Box 12008La Jolla, CA 92039-2008 · (858) 677-9222
Phone(858) 677-9222
Sole ProprietorNo
Medical School CMSNew York University School Of MedicineGraduated 2000
Enumeration DateNovember 15, 2006
Last NPPES UpdateMarch 12, 20263 updates tracked since enumeration
NPPES CertifiedMarch 12, 2026
✔ NPI 1073685764 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Forensic PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084F0202X
License✔ Licensed in CA · A79691
Definition
Forensic Psychiatry is a subspecialty with psychiatric focus on interrelationships with civil, criminal and administrative law, evaluation and specialized treatment of individuals involved with the legal system, incarcerated in jails, prisons, and forensic psychiatry hospitals.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License A79691 (CA)
3252 HOLIDAY CT STE 205, La Jolla, CA 92037
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jason R. Kornberg M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820304827
PECOS Enrollment IDI20150908000990
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jason Kornberg reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Jason R. Kornberg, M.D., A Professional Corporation
Same address
Psychiatry
3252 HOLIDAY CT STE 205
La Jolla, CA 92037
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Jason R Kornberg MD A Professional Corporation
NPI 1841440419 (858) 677-9222

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
71 services11 patients

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PAUL SANTERO
Psychologist (Clinical)
3252 HOLIDAY CT STE 205
LA JOLLA, CA 92037
San Diego County (619) 750-0970
SAINT JOSEPH PSYCHOLOGICAL CLINIC INC
Psychologist (Clinical)
3252 HOLIDAY CT STE 205
LA JOLLA, CA 92037
San Diego County (619) 507-9294
MR. ALLAN EDWARD MALLINGER M.D.
Psychiatry & Neurology (Psychiatry)
3252 HOLIDAY CT STE 205
LA JOLLA, CA 92037
San Diego County (619) 994-3053
AHMED MAKHLOUF M.D.
Psychiatry & Neurology (Psychiatry)
3252 HOLIDAY CT STE 205
LA JOLLA, CA 92037
San Diego County (858) 255-0663
JASON R. KORNBERG, M.D., A PROFESSIONAL CORPORATION
Psychiatry & Neurology (Psychiatry)
3252 HOLIDAY CT STE 205
LA JOLLA, CA 92037
San Diego County (858) 677-9222

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jason Kornberg's NPI number?

The NPI number for Jason Kornberg is 1073685764. It was assigned to this individual provider in the NPPES registry on November 15, 2006.

Where is Jason Kornberg located?

Jason Kornberg practices at 3252 Holiday Ct Ste 205, La Jolla, CA 92037. The listed phone number is (858) 677-9222.

What is Jason Kornberg's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Forensic Psychiatry, with taxonomy code 2084F0202X.

Is Jason Kornberg enrolled in Medicare?

Yes. Jason Kornberg is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jason Kornberg's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jason Kornberg reassigns Medicare benefits to Jason R. Kornberg, M.D., A Professional Corporation (La Jolla, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jason Kornberg's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jason Kornberg was last updated on March 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.