Individual provider Active NPI

Shmuel Kaufman, PA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1295186443
Registry record updated Mar 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
019896 Issued in NY
Practice address
1129 E 14TH St
Brooklyn, NY 11230-4813
Phone
(754) 300-6710
NPI assigned
Jun 29, 2016
Last updated
Mar 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363AM0700X
Physician Assistant 363A00000X 019896 NY Primary

Addresses

Primary practice location

1129 E 14TH St
Brooklyn, NY 11230-4813

Mailing address

1129 E 14TH St
Brooklyn, NY 11230-4813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20161219002032 NJ Practitioner - Physician Assistant 3274814884 Practice locations: Edison, NJ

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shmuel Kaufman R.P.a. Services PLLC Single Specialty CurrentSince Dec 1, 2022 Accepting new patients

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, 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": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742083200000",
    "number": "1295186443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 E 14TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112304813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 E 14TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112304813",
            "telephone_number": "754-300-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "SHMUEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-29",
        "last_updated": "2025-03-16",
        "certification_date": "2025-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.