Individual provider Active NPI

John M Kaufman, MSW, LICSW

  • Clinical Social Worker
  • Golden Valley, MN
National Provider Identifier
1659878866
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
21928 Issued in MN
Practice address
5905 Golden Valley Rd
Golden Valley, MN 55422-4463
Phone
(952) 542-4842
NPI assigned
Apr 12, 2018
Last updated
May 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 21928 MN Primary

Addresses

Primary practice location

5905 Golden Valley Rd
Golden Valley, MN 55422-4463

Mailing address

3952 17TH Ave S
Minneapolis, MN 55407-2833
Phone (651) 383-2502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180517000887 MN Practitioner - Clinical Social Worker 7113282328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Jewish Family and Children's Service of MinneapolisGroup PAC ID 3870532500, 7 clinicians

Practice addresses (Care Compare)

5905 Golden Valley Rd
Golden Valley, MN 55422-4463
Phone (952) 546-0616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family & Children's Service of Minneapolis CurrentSince Apr 30, 2018 Accepting new patients

Locations

5905 Golden Valley Rd
Minneapolis, MN 55422
Phone (952) 546-0616

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, 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": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1659878866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3952 17TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554072833",
            "telephone_number": "651-383-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5905 GOLDEN VALLEY RD",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224463",
            "telephone_number": "952-542-4842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-12",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.