Individual provider Active NPI

Charles T Kaufmann

  • Family Medicine Physician
  • West Bend, WI
National Provider Identifier
1760564595
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26397 Issued in WI
Practice address
1700 W Paradise Dr
West Bend, WI 53095-9795
Phone
(262) 334-3451
NPI assigned
Oct 20, 2006
Last updated
Apr 22, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26397 WI Primary

Addresses

Primary practice location

1700 W Paradise Dr
West Bend, WI 53095-9795

Mailing address

1700 W Paradise Dr
West Bend, WI 53095-9795

Other identifiers 1

IdentifierTypeStateIssuer
1018OtherINTERNAL ID-MOTOR VEHICLE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20100201000079 WI Practitioner - Family Practice 2163565045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1700 W Paradise Dr
West Bend, WI 53095-9795
Phone (262) 334-3451

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions22
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26397WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince May 1, 2013 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Current Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

1701 Fond du Lac Ave
Kewaskum, WI 53040
Phone (262) 626-4616

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

840 N 87th St
Wauwatosa, WI 53226
Phone (414) 805-5540

1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451

Interoperability endpoints

  • Direct secure messaging: ckaufmanndo125448@direct.froedtert.com

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1760564595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 W PARADISE DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W PARADISE DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959795",
            "telephone_number": "262-334-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMANN",
        "first_name": "CHARLES",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "26397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL ID-MOTOR VEHICLE ID",
            "identifier": "1018",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

Verify at the official NPI Registry.