Active NPI
Jessie G Kaufman, LISW
- Clinical Social Worker
- Taos, NM
National Provider Identifier
1710067921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I-05995
- Practice address
- 235 Paseo del Canon E
Taos, NM 87571-6239 - Phone
- (505) 613-3163
- NPI assigned
- Oct 16, 2006
- Sex
- Female
- 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 Social Worker | 1041C0700X | I-05995 | NM | Primary |
Addresses
Primary practice location
235 Paseo del Canon E
Taos, NM 87571-6239
Mailing address
PO Box 450
Arroyo Hondo, NM 87513-0450
Phone (505) 776-3987
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27107761 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- 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 |
|---|---|---|---|---|
| I20151105001120 | NM | Practitioner - Clinical Social Worker | 1951611888 | Practice locations: Taos, NM |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1399 Weimer Rd
Suite 200
Taos, NM 87571-6340
Phone (575) 758-2224
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I-05995 | NM | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433116800000",
"number": "1710067921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 450",
"city": "ARROYO HONDO",
"state": "NM",
"postal_code": "875130450",
"telephone_number": "505-776-3987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 PASEO DEL CANON E",
"city": "TAOS",
"state": "NM",
"postal_code": "875716239",
"telephone_number": "505-613-3163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUFMAN",
"first_name": "JESSIE",
"middle_name": "G",
"name_prefix": "Mrs.",
"credential": "LISW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-16",
"last_updated": "2015-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "I-05995",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "27107761",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Taos, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; 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.