Active NPI
Michaela U Kauffmann, PSYD
- Psychologist
- Waterbury, CT
National Provider Identifier
1487763413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 001965
- Practice address
- 133 Scovill St
Suite 211
Waterbury, CT 06706-1127 - Phone
- (203) 573-9521
- Fax
- (203) 573-8708
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 001965 | CT | Primary |
Addresses
Primary practice location
133 Scovill St
Suite 211
Waterbury, CT 06706-1127
Mailing address
133 Scovill St
Suite 211
Waterbury, CT 06706-1127
Phone (203) 573-9521
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 060001965CT01 | Other | CT | BLUE SHIELD |
| 004144333 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
600 3Rd Ave
FL 2
New York, NY 10016-1909
600 3Rd Ave FL
Suite 2
New York, NY 10016-1919
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026271 | NY | MD | Physical Therapist |
| 1965 | CT | MD | Medical Physician Assistant |
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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- New York, NY
- NPI 1932975919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283385600000",
"number": "1487763413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "133 SCOVILL ST",
"address_2": "SUITE 211",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067061127",
"telephone_number": "203-573-9521",
"fax_number": "203-573-8708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 SCOVILL ST",
"address_2": "SUITE 211",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067061127",
"telephone_number": "203-573-9521",
"fax_number": "203-573-8708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUFFMANN",
"first_name": "MICHAELA",
"middle_name": "U",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2010-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CT",
"license": "001965",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "060001965CT01",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004144333",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; 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.
- 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.