Jeffrey Michael Koffler, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

021760 Issued in CT

Practice address

39 Glenbrook Rd
1G
Stamford, CT 06902-2968

Phone

(203) 323-2500

Fax

(203) 323-3003

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Catholic Charities of Fairfield County, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Stamford, CT
  • NPI 1831314269
  NPD (past)
• Catholic Charities of Fairfield County, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Norwalk, CT
  • NPI 1972727394
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1255499513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 GLENBROOK RD",
            "address_2": "1G",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069022968",
            "telephone_number": "203-323-2500",
            "fax_number": "203-323-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 GLENBROOK RD",
            "address_2": "1G",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069022968",
            "telephone_number": "203-323-2500",
            "fax_number": "203-323-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOFFLER",
        "first_name": "JEFFREY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "021760",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "137114",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001217603",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "56010021760CT1",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "033247",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLAN",
            "identifier": "P1082129",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Debra Knopoff, RD
• Florence Angela Knox, M.D.
• Walter Michael Kobialka, MD
• Natasha Alexandra Kodiak, BCBA, LBA
• Rita Koenig
• Katherine Kogut, PA
• Barbara C Kohn, PA-C
• Bibek Koirala, M.D.
• Saranue Sharma Koirala
• Susan Gail Kolbrenner, M.S.CCC.SLP

• Psychiatry Physician in Stamford, CT
• Providers in Stamford, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.