J. RANDOLPH BURNHAM PH.D.
NPI 1417005554
Psychologist in Westport, CT

Active since January 08, 2007PECOS EnrolledAccepts Medicare Assignment
18 KINGS HWY S, WESTPORT, CT 06880(203) 227-7199 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About J. Randolph Burnham Ph.d. NPPES

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

J. RANDOLPH BURNHAM PH.D. (NPI 1417005554) is an individual psychologist in Westport, Connecticut, licensed in Michigan (1376) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS and is a graduate of Other (1971).

NPPES Registry Identity

NPI1417005554
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameJ. RANDOLPH BURNHAMCredential: PH.D.
Location Address18 KINGS HWY SWestport, CT 06880-4710
Mailing Address18 Kings Hwy SWestport, CT 06880-4710 · (203) 227-7199
Sole ProprietorYes
Medical School CMSOtherGraduated 1971
Enumeration DateJanuary 8, 2007
Last NPPES UpdateSeptember 11, 2025
NPI 1417005554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in MI · 1376
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 464 (CT)
18 KINGS HWY S, Westport, CT 06880

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

J. Randolph Burnham Ph.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 ID4284822404
PECOS Enrollment IDI20110103000409
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.

Other Providers at the Same Location NPPES

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

Psychologist
18 KINGS HWY S
WESTPORT, CT 06880

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 J. Randolph Burnham's NPI number?

The NPI number for J. Randolph Burnham is 1417005554. It was assigned to this individual provider in the NPPES registry on January 8, 2007.

Where is J. Randolph Burnham located?

J. Randolph Burnham practices at 18 Kings Hwy S, Westport, CT 06880. The listed phone number is (203) 227-7199.

What is J. Randolph Burnham's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is J. Randolph Burnham enrolled in Medicare?

Yes. J. Randolph Burnham 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.

When was this NPI record last updated?

The NPPES record for J. Randolph Burnham was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.