Active NPI
Kenneth A Stampfer, MD
- Ophthalmology Physician
- Cambridge, MA
National Provider Identifier
1134193501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 31739
- Practice address
- 625 Mount Auburn St
Suite 100
Cambridge, MA 02138-4555 - Phone
- (617) 492-1174
- Fax
- (617) 492-6807
- NPI assigned
- Feb 14, 2006
- Last updated
- Dec 17, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 31739 | MA | Primary |
Addresses
Primary practice location
625 Mount Auburn St
Suite 100
Cambridge, MA 02138-4555
Mailing address
50 Staniford St
Suite 600
Boston, MA 02114-2517
Phone (617) 367-4800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2020432 | Medicaid | MA | |
| 110034754A | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450310400000",
"number": "1134193501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 STANIFORD ST",
"address_2": "SUITE 600",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142517",
"telephone_number": "617-367-4800",
"fax_number": "617-723-7028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 MOUNT AUBURN ST",
"address_2": "SUITE 100",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021384555",
"telephone_number": "617-492-1174",
"fax_number": "617-492-6807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAMPFER",
"first_name": "KENNETH",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-14",
"last_updated": "2015-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MA",
"license": "31739",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2020432",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110034754A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.