Clinton L. Kauffman, MD
Individual provider Active NPI Family Medicine Physician · Winamac, IN
NPI 1013062686 · NPPES record last updated Mar 13, 2020
Key facts
- NPI
- 1013062686
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 01057944A (IN)
- Practice address
- 540 Hospital Dr
Winamac, IN 46996 - Phone
- (574) 946-2194
- Fax
- (574) 946-2196
- NPI assigned
- Jan 24, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 3
Owned or controlled facilities with NPI records 14
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Virginia Commonwealth University, School of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pulaski Memorial Hospital
Practice addresses (Care Compare)
540 Hospital Dr
Winamac, IN 46996-1173
Phone (574) 946-2194
616 E 13TH St
Winamac, IN 46996-1117
Phone (574) 946-2100
Hospital & facility affiliations
- Elara Caring
- Pulaski Memorial Hospital
- Pulaski Memorial Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 14
| Facility | Type | Role | Since |
|---|---|---|---|
| Pulaski Memorial Hospital |
Hospital | Corporate Director (14.29%) | Aug 1, 2019 |
| Pulaski Memorial Hospital |
Hospital | Corporate Director (14.29%) | Aug 1, 2019 |
| Pulaski Health Care Center |
Skilled nursing facility | Corporate Director | Aug 1, 2019 |
| Parkview Haven |
Skilled nursing facility | Corporate Officer (14.29%) Corporate Director (14.29%) |
Aug 1, 2019 Aug 1, 2019 |
| Kingston Health Center of Fort Wayne |
Skilled nursing facility | Trustee of the SNF | Dec 16, 2025 |
| Briarcliff Health & Rehabilitation Center |
Skilled nursing facility | Corporate Director (100%) | Jan 1, 2024 |
| South Shore Health & Rehabilitation Center |
Skilled nursing facility | Corporate Director (100%) | Jan 1, 2024 |
| Asbury Towers Health Care Center |
Skilled nursing facility | Managing Control - Governing Body | Jul 1, 2024 |
| Healthwin Health & Rehabilitation |
Skilled nursing facility | Trustee of the SNF | Jan 8, 2025 |
| Pulaski Memorial Hospital |
Rural health clinic | Corporate Director (14.29%) | Aug 1, 2019 |
| Pulaski Memorial Hospital Francesville Family Medicine |
Rural health clinic | Corporate Director | Aug 1, 2019 |
| Pulaski Memorial Hospital North Judson Family Medicine |
Rural health clinic | Corporate Director | Aug 1, 2019 |
| Pulaski Memorial Hospital Knox Medical Center |
Rural health clinic | Corporate Director | Aug 1, 2019 |
| Pulaski Memorial Hospital Culver Medical Center |
Rural health clinic | Corporate Director | Aug 1, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070828000370 | IN | Practitioner - Family Practice |
8325017957 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pulaski Memorial Hospital | Current |
Accepting new patients | |
| Pulaski Memorial Hospital | Current |
Accepting new patients | |
| Pulaski Memorial Hospital | Current | Accepting new patients | |
| Major Hospital | Past | Accepting new patients | |
| Family & Women'S Health Services | Family Medicine | Past |
Accepting new patients |
Locations
540 Hospital Dr
Winamac, IN 46996
Phone (574) 935-4327
616 E 13th St
Winamac, IN 46996
Phone (574) 946-2100
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/pulaski-0086e204
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01057944A | IN | Yes |
Addresses
Primary practice location
540 Hospital Dr
Winamac, IN 46996
Mailing address
540 Hospital Dr
Winamac, IN 46996-1173
Phone (574) 946-2194
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200444820 | Medicaid | IN | |
| 01057944A | Other | IN | STATE LICENSE |
Other providers in Winamac, IN
- Hannah Howell
- Charles Randall Hutton
- Jennifer M Gudas OD, PC
- Brian Alan Johnson
- David P Johnson
- Michael Ryan Keller
- Mijin Kim
- Melissa Kletz
- Christine M Knapp
- Knox-Winamac Community Health Centers, Inc.
All providers in Winamac, IN · Family Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.