NPIMap

Individual provider Active NPI

Walter Ernst Kaufmann, MD

  • Cardiovascular Disease Physician
  • Port Jervis, NY
National Provider Identifier
1083609366
Registry record updated Sep 24, 2010
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Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
149887 Issued in NY
Practice address
161 E Main St
Community Medical Care
Port Jervis, NY 12771-2113
Phone
(845) 858-2666
Fax
(845) 858-2662
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 149887 NY Primary

Addresses

Primary practice location

161 E Main St
Community Medical Care
Port Jervis, NY 12771-2113

Mailing address

20 Grand Street
3Rd Floor
Warwick, NY 10990-1035
Phone (845) 987-3920

Other identifiers 1

IdentifierTypeStateIssuer
00722656MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100209000746 NY Practitioner - Cardiovascular Disease (Cardiology) 0244373454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Charity Health System Medical Group, P.C.Group PAC ID 1658262084, 157 clinicians

Practice addresses (Care Compare)

5 Skinner St
Port Jervis, NY 12771-2226
Phone (845) 858-2666

Hospital & facility affiliations

  • Residential Healthcare of NE PA, LLC Home health agency, Moosic, PA, CCN 397726
  • Bon Secours Community Hospital Hospital, Port Jervis, NY, CCN 330135
  • Morristown Medical Center Hospital, Morristown, NJ, CCN 310015
  • Westchester Medical Center Hospital, Valhalla, NY, CCN 330234
  • Good Samaritan Hospital of Suffern Hospital, Suffern, NY, CCN 330158
  • Garnet Health Medical Center Hospital, Middletown, NY, CCN 330126

Merit-based Incentive Payment System (MIPS)

Final score
96.73 of 100Reported as apm
Quality
87.82
Promoting interoperability
92
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
149887NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Charity Health System Medical Group, P.C. CurrentSince Dec 6, 2009 Accepting new patients
Metropolitan Cardiology Consultants, LLC Cardiovascular Disease PastSince Dec 6, 2009 Accepting new patients

Locations

161 E Main St
Port Jervis, NY 12771
Phone (845) 856-3284

5 Skinner St
Port Jervis, NY 12771
Phone (845) 368-0330

160 E Main St
Port Jervis, NY 12771
Phone (845) 856-7000

20 Grand St
Fl 3
Warwick, NY 10990
Phone (845) 987-3901

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1083609366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GRAND STREET",
            "address_2": "3RD FLOOR",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109901035",
            "telephone_number": "845-987-3920",
            "fax_number": "845-987-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 E MAIN ST",
            "address_2": "COMMUNITY MEDICAL CARE",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127712113",
            "telephone_number": "845-858-2666",
            "fax_number": "845-858-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMANN",
        "first_name": "WALTER",
        "middle_name": "ERNST",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "149887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00722656",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jervis, NY

Sources for this page

Verify at the official NPI Registry.