Active NPI
Larry Kaufman, LMT
- Massage Therapist
- Portland, OR
National Provider Identifier
1558494062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 12482
- Practice address
- 1423 SE 23Rd Ave
Portland, OR 97214-3908 - Phone
- (503) 236-3108
- Fax
- (503) 236-3239
- NPI assigned
- Mar 13, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 12482 | OR | Primary |
| Massage Therapist | 225700000X | MA00009527 | WA |
Addresses
Primary practice location
1423 SE 23Rd Ave
Portland, OR 97214-3908
Mailing address
1423 SE 23Rd Ave
Portland, OR 97214-3908
Phone (503) 236-3108
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12482 | OR | MD | Massage Therapist |
| MA00009527 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Heights Integrative Therapy Inc | Past | Accepting new patients | |
| New Heights Integrative Therapy, Inc. | Past | Accepting new patients |
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.
-
dba New Heights Physical Therapy Plus
- Physical Therapist
- Portland, OR
- NPI 1558308478
-
dba New Heights Physical Therapy, Plus
- Physical Therapist
- Vancouver, WA
- NPI 1922126937
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1558494062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1423 SE 23RD AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972143908",
"telephone_number": "503-236-3108",
"fax_number": "503-236-3239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1423 SE 23RD AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972143908",
"telephone_number": "503-236-3108",
"fax_number": "503-236-3239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUFMAN",
"first_name": "LARRY",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "12482",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00009527",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.