Active NPI
Noah K Kaufman, PHD
- Psychologist
- Las Cruces, NM
National Provider Identifier
1780658401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 905
- Practice address
- 1188 W Hadley Ave
Las Cruces, NM 88005-2425 - Phone
- (575) 526-9090
- Fax
- (575) 526-8787
- NPI assigned
- Feb 17, 2006
- Last updated
- Jul 27, 2010
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 905 | NM | Primary |
Addresses
Primary practice location
1188 W Hadley Ave
Las Cruces, NM 88005-2425
Mailing address
PO Box 16198
Las Cruces, NM 88004-6198
Phone (575) 526-9090
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 62350030 | 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 |
|---|---|---|---|---|
| I20041021000982 | NM | Practitioner - Clinical Psychologist | 6901867357 | Practice locations: Las Cruces, NV |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1188 W Hadley Ave
Las Cruces, NM 88005-2425
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 905 | NM | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280188800000",
"number": "1780658401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 16198",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880046198",
"telephone_number": "575-526-9090",
"fax_number": "575-526-8787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1188 W HADLEY AVE",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880052425",
"telephone_number": "575-526-9090",
"fax_number": "575-526-8787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUFMAN",
"first_name": "NOAH",
"middle_name": "K",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-17",
"last_updated": "2010-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NM",
"license": "905",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "62350030",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; 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.