Individual provider Active NPI

Keith C Kaufman, MSPT

  • Physical Therapist
  • Lander, WY
National Provider Identifier
1508195983
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT - 1088 Issued in WY
Practice address
8204 Highway 789
Lander, WY 82520-2941
Phone
(307) 349-0711
NPI assigned
Dec 15, 2009
Last updated
Dec 15, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

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 PT - 1088 WY Primary

Addresses

Primary practice location

8204 Highway 789
Lander, WY 82520-2941

Mailing address

935 McDougall Dr
Lander, WY 82520-3515
Phone (307) 349-0711

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251119002286 WY Practitioner - Physical Therapist in Private Practice 5698266450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Barry University School of Podiatric Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sinks Canyon Therapies IncGroup PAC ID 6800022716, 7 clinicians

Practice addresses (Care Compare)

634 Main St
Lander, WY 82520-3034
Phone (307) 332-2715

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT - 1088WYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sinks Canyon Therapies Inc Physical Therapist CurrentSince Aug 21, 2025 Accepting new patients
Osback Pharmaceuticals Inc PastSince Aug 21, 2025 Accepting new patients

Locations

634 Main St
Lander, WY 82520
Phone (307) 332-2715

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": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260835200000",
    "number": "1508195983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 MCDOUGALL DR",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825203515",
            "telephone_number": "307-349-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8204 HIGHWAY 789",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825202941",
            "telephone_number": "307-349-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "KEITH",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-15",
        "last_updated": "2009-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "PT - 1088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lander, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; 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.