Marcia Bonnie Kaufman, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

VA0810004426 Issued in VA

Practice address

115 Park St SE
Suite 207
Vienna, VA 22180-4653

Phone

(703) 938-9090

Fax

(703) 938-9091

NPI assigned

Jan 31, 2006

Last updated

Jul 8, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 8, 2017 through Feb 8, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Familyfirst Psychological Services, PC

  • Clinical Child & Adolescent Psychologist
  • Vienna, VA
  • NPI 1912214198
  NPD (past)

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310083200000",
    "number": "1306817994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 PARK ST SE",
            "address_2": "SUITE 207",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804653",
            "telephone_number": "703-938-9090",
            "fax_number": "703-938-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 PARK ST SE",
            "address_2": "SUITE 207",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804653",
            "telephone_number": "703-938-9090",
            "fax_number": "703-938-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "MARCIA",
        "middle_name": "BONNIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2011-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS006137L",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "VA0810004426",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "DC",
            "license": "PSY1000608",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natavan Karsh
• Ranjeetha Katepalli
• Kathy Katusha, MD
• Kaufman Allergy Asthma and Immunology, PLLC
• Karen Beth Kaufman, D.O.
• Ayesha Kazmi, LCSW
• Nicole Denise Kazuba, LPC
• Kathleen Keating
• Kebros & Associates, LLC (SmartCare Hospice)
• Keeton Enterprises, Inc.

• Psychologist in Vienna, VA
• Providers in Vienna, VA by specialty
• Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.