Individual provider Active NPI

Jay D Kauffman, PT

  • Physical Therapist
  • Pennsburg, PA
National Provider Identifier
1407816192
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT006662-L Issued in PA
Practice address
2767 Geryville Pike
Pennsburg, PA 18073-2306
Phone
(215) 679-0105
Fax
(215) 679-0722
NPI assigned
Mar 25, 2006
Last updated
Jan 2, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT006662-L PA Primary

Addresses

Primary practice location

2767 Geryville Pike
Pennsburg, PA 18073-2306

Mailing address

33 Douglass Rd
Lansdale, PA 19446-1450
Phone (215) 997-3951

Other identifiers 1

IdentifierTypeStateIssuer
0017868680004MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040205000005 PA Practitioner - Physical Therapist in Private Practice 4981597804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upper Perk Physical Therapy and Sports Rehab, IncGroup PAC ID 8527053859, 8 clinicians

Practice addresses (Care Compare)

2767 Geryville Pike
Pennsburg, PA 18073-2306
Phone (215) 679-0105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT006662-LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Perk Physical Therapy & Sports Rehab., Inc Physical Therapist CurrentSince Nov 12, 2003 Accepting new patients
Southeastern Health Services of Pennsylvania, LLC PastSince Dec 9, 2003 Accepting new patients

Locations

2767 Geryville Pike
Pennsburg, PA 18073
Phone (215) 679-0105

2771 Geryville Pike
Pennsburg, PA 18073
Phone (215) 679-0105

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": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1407816192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 DOUGLASS RD",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194461450",
            "telephone_number": "215-997-3951",
            "fax_number": "215-997-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2767 GERYVILLE PIKE",
            "city": "PENNSBURG",
            "state": "PA",
            "postal_code": "180732306",
            "telephone_number": "215-679-0105",
            "fax_number": "215-679-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFFMAN",
        "first_name": "JAY",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT006662-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017868680004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.