Active NPI
Clark Robert Kaufman, MD
- Specialist
- Lancaster, PA
National Provider Identifier
1326036468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MD036013E
- Practice address
- 2445 Marietta Ave
Lancaster, PA 17601-1942 - Phone
- (717) 393-1365
- Fax
- (717) 393-8540
- NPI assigned
- Oct 12, 2005
- Last updated
- Oct 7, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MD036013E | PA | Primary |
| Allergy & Immunology Physician | 207K00000X | MD036013E | PA |
Addresses
Primary practice location
2445 Marietta Ave
Lancaster, PA 17601-1942
Mailing address
2445 Marietta Ave
Lancaster, PA 17601-1942
Phone (717) 393-1365
Other identifiers 19
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 117425 | Other | PA | UNISON |
| 0421114 | Other | BC/BS PERSONAL CHOICE | |
| 1519641 | Other | GATEWAY | |
| 7014809 | Other | GEISINGER | |
| 7125391002 | Other | CIGNA | |
| 001163584 | Medicaid | PA | |
| 0099126000 | Other | KEYSTONE HEALTH PLAN EAST | |
| 421114GLF | Other | PA | MEDICARE, PIN UNSPECIFIED |
| 0099126000 | Other | AMERIHEALTH HMO | |
| 030003465 | Other | RAILROAD MEDICARE | |
| 0412114 | Other | KEYSTONE HEALTH PLAN CENT | |
| 0466380 | Other | AETNA | |
| 117425 | Other | THREE RIVERS (MEDPLUS) | |
| 1326036468 | Other | PA | NPI |
| 248732 | Other | MAMSI | |
| 01799101 | Other | CAPITAL BLUE CROSS | |
| 0421114 | Other | PA | HIGHMARK BLUE SHIELD |
| 30108A | Other | AMERIHEALTH MERCY | |
| 0011635840001 | Other | PA | ACCESS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD036013E | PA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412640000000",
"number": "1326036468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2445 MARIETTA AVE",
"city": "LANCASTER",
"state": "PA",
"postal_code": "176011942",
"telephone_number": "717-393-1365",
"fax_number": "717-393-8540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2445 MARIETTA AVE",
"city": "LANCASTER",
"state": "PA",
"postal_code": "176011942",
"telephone_number": "717-393-1365",
"fax_number": "717-393-8540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUFMAN",
"first_name": "CLARK",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-12",
"last_updated": "2014-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "PA",
"license": "MD036013E",
"primary": true
},
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "PA",
"license": "MD036013E",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON",
"identifier": "117425",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS PERSONAL CHOICE",
"identifier": "0421114",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY",
"identifier": "1519641",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEISINGER",
"identifier": "7014809",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "7125391002",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001163584",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE HEALTH PLAN EAST",
"identifier": "0099126000",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE, PIN UNSPECIFIED",
"identifier": "421114GLF",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH HMO",
"identifier": "0099126000",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "030003465",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE HEALTH PLAN CENT",
"identifier": "0412114",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0466380",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THREE RIVERS (MEDPLUS)",
"identifier": "117425",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1326036468",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "248732",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "01799101",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "0421114",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH MERCY",
"identifier": "30108A",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACCESS",
"identifier": "0011635840001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lancaster, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.