Sean L. Kaufman, D.P.M

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

MD002619 Issued in NJ

Practice address

528 Boulevard
Kenilworth, NJ 07033-1657

Phone

(908) 276-6624

Fax

(908) 709-0163

NPI assigned

May 23, 2005

Reactivated

Mar 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Innovative Foot and Ankle, P.a.

  • Primary Podiatric Medicine Podiatrist
  • Kenilworth, NJ
  • NPI 1023177532

  O20060720000037

  Same enrollment

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Innovative Foot and Ankle PAGroup PAC ID 7315950268, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Innovative Foot and Ankle, P.a.

  • Primary Podiatric Medicine Podiatrist
  • Kenilworth, NJ
  • NPI 1023177532
  Medicare reassignment Care Compare group NPD Authorized official
• Innovative Foot and Ankle, P.a.

  • Foot & Ankle Surgery Podiatrist
  • Montclair, NJ
  • NPI 1861922320
  NPD Authorized official

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1821091018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 BOULEVARD",
            "city": "KENILWORTH",
            "state": "NJ",
            "postal_code": "070331657",
            "telephone_number": "908-276-6624",
            "fax_number": "908-709-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 BOULEVARD",
            "city": "KENILWORTH",
            "state": "NJ",
            "postal_code": "070331657",
            "telephone_number": "908-276-6624",
            "fax_number": "908-709-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "SEAN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2008-04-17",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NJ",
            "license": "MD002619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8719403",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sin Ki Ho, RDN, CDN
• Innovative Foot and Ankle, P.a.
• Janwelle Medical Diagnostic Services
• Bhavani Jeereddy, MD
• Erica Kane
• Ahmad Kazemi, MD
• Courtney Keating, LAT, ATC
• Kenilworth Dental Associates, LLC
• Kenilworth Primary Care LLC
• Kenilworth School District

• Primary Podiatric Medicine Podiatrist in Kenilworth, NJ
• Providers in Kenilworth, NJ by specialty
• Primary Podiatric Medicine Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; 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.

Verify at the official NPI Registry.