Individual provider Active NPI

J Mark Kaufman, O.D.

  • Optometrist
  • Sugarcreek, OH
National Provider Identifier
1316902661
Registry record updated Mar 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3807/220 Issued in OH
Practice address
233 N. Factory St.
Sugarcreek, OH 44681
Phone
(330) 852-2512
NPI assigned
Apr 19, 2006
Last updated
Mar 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3807/220 OH Primary

Addresses

Primary practice location

233 N. Factory St.
Sugarcreek, OH 44681

Mailing address

PO Box 245
Sugarcreek, OH 44681-0245
Phone (330) 852-2512

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080701000387 OH Practitioner - Optometry 7517039886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Insight Vision Care IncGroup PAC ID 0244302511, 7 clinicians

Practice addresses (Care Compare)

232 N Factory St
Sugarcreek, OH 44681-0245
Phone (330) 852-2512

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3807/220OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Vision Care, Inc. Optometrist CurrentSince Oct 1, 1985 Accepting new patients

Locations

210 Cross St
Newcomerstown, OH 43832
Phone (740) 498-7181

110 Andreas Dr NE
#A
Sugarcreek, OH 44681
Phone (330) 852-2512

233 Factory St NE
Sugarcreek, OH 44681
Phone (330) 852-2512

Organizations & group practices 1

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268006400000",
    "number": "1316902661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 245",
            "city": "SUGARCREEK",
            "state": "OH",
            "postal_code": "446810245",
            "telephone_number": "330-852-2512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 N. FACTORY ST.",
            "city": "SUGARCREEK",
            "state": "OH",
            "postal_code": "44681",
            "telephone_number": "330-852-2512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "J",
        "middle_name": "MARK",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2010-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3807/220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugarcreek, OH

Sources for this page

Verify at the official NPI Registry.