Individual provider Active NPI

Kerry R Kauffman, M.D.

  • Pediatrics Physician
  • Collegeville, PA
National Provider Identifier
1669677985
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD440382 Issued in PA
Practice address
17 Iron Bridge Dr Ste 100
Collegeville, PA 19426-2042
Phone
(484) 622-6340
Fax
(484) 622-6357
NPI assigned
Jun 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD440382 PA Primary

Addresses

Primary practice location

17 Iron Bridge Dr Ste 100
Collegeville, PA 19426-2042

Mailing address

PO Box 789967
Philadelphia, PA 19178-9967
Phone (484) 622-7395

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210706002811 PA Practitioner - Pediatric Medicine 9931501517 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fornance Physician Services IncGroup PAC ID 8527962661, 105 clinicians

Practice addresses (Care Compare)

100 Market St
Suite 300
Collegeville, PA 19426-4927
Phone (215) 997-9441

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD440382PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fornance Physician Services, Inc CurrentSince May 1, 2021 Accepting new patients
Einstein Community Health Associates, Inc CurrentSince Jan 1, 2026 Accepting new patients
Fornance Physician Services, Inc Current Accepting new patients
Einstein Community Health Associates, Inc CurrentSince Jan 1, 2026 Accepting new patients
Fornance Physician Services, Inc. CurrentSince May 1, 2021 Accepting new patients
Fornance Physician Services, Inc. Past Accepting new patients

Locations

17 Iron Bridge Dr
#100
Collegeville, PA 19426
Phone (484) 622-6340

100 Market St
Ste 300
Collegeville, PA 19426
Phone (484) 622-6400

1330 Powell St
Ste 308
Norristown, PA 19401
Phone (484) 622-7371

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

101 E Olney Ave
Ste C5
Philadelphia, PA 19120
Phone (215) 927-1937

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1669677985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 789967",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191789967",
            "telephone_number": "484-622-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 IRON BRIDGE DR STE 100",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194262042",
            "telephone_number": "484-622-6340",
            "fax_number": "484-622-6357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFFMAN",
        "first_name": "KERRY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD440382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collegeville, PA

Sources for this page

Verify at the official NPI Registry.