Active NPI
Gus Bernd Kaufman Jr., PH.D.
- Clinical Psychologist
- Decatur, GA
National Provider Identifier
1659598720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 837
- Practice address
- 1834 Clairmont Rd
Decatur, GA 30033-3405 - Phone
- (404) 875-8777
- NPI assigned
- Apr 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 837 | GA | Primary |
Addresses
Primary practice location
1834 Clairmont Rd
Decatur, GA 30033-3405
Mailing address
682 Elkmont Dr NE
Atlanta, GA 30306-3623
Phone (404) 875-8777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081226000159 | GA | Practitioner - Clinical Psychologist | 1254493356 | Practice locations: Atlanta, GA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
Atlanta, GA 30306
Phone (404) 371-9171
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 837 | GA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659598720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "682 ELKMONT DR NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303063623",
"telephone_number": "404-875-8777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1834 CLAIRMONT RD",
"city": "DECATUR",
"state": "GA",
"postal_code": "300333405",
"telephone_number": "404-875-8777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUFMAN",
"first_name": "GUS",
"middle_name": "BERND",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
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.
- 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.