Individual provider Active NPI

Britney Elise Kaufman, PA

  • Physician Assistant
  • Ontario, CA
National Provider Identifier
1255500724
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21951 Issued in CA
Practice address
3333 Concours St
BLDG 1, Suite 1201
Ontario, CA 91764
Phone
(909) 476-4077
NPI assigned
Feb 28, 2008
Last updated
Nov 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA21951 CA Primary
Dermatology Physician 207N00000X PA21951 CA

Addresses

Primary practice location

3333 Concours St
BLDG 1, Suite 1201
Ontario, CA 91764

Mailing address

3333 Concours St.
BLDG 1, Suite 1201
Ontario, CA 91764
Phone (909) 476-4077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120417000589 CA Practitioner - Physician Assistant 3779744867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Dermatology Bar a Medical CorporationGroup PAC ID 2062940109, 3 clinicians

Practice addresses (Care Compare)

3333 Concours
Suite 1201
Ontario, CA 91764-6539
Phone (909) 476-4077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
21951CAMDClinical Psychologist
PA21951CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Hospital of Riverside LLC Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Hemet Valley Medical Center Past Accepting new patients
Bradley Mudge MD Inc Past Accepting new patients
Beverly Hills Dermatology Surgery Center Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1255500724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 CONCOURS ST.",
            "address_2": "BLDG 1, SUITE 1201",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "91764",
            "telephone_number": "909-476-4077",
            "fax_number": "909-476-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 CONCOURS ST",
            "address_2": "BLDG 1, SUITE 1201",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "91764",
            "telephone_number": "909-476-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "BRITNEY",
        "middle_name": "ELISE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-28",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21951",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "PA21951",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

Verify at the official NPI Registry.