Active NPI
R Lisa Kaufman, NP
- Nurse Practitioner
- Worcester, MA
National Provider Identifier
1891761946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 200050
- Practice address
- 630 Plantation St
Worcester, MA 01605 - Phone
- (508) 595-2505
- Fax
- (508) 854-0650
- NPI assigned
- Feb 28, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 200050 | MA | Primary |
Addresses
Primary practice location
630 Plantation St
Worcester, MA 01605
Mailing address
630 Plantation St
Wot 12TH Floor Attn Physician Services
Worcester, MA 01605
Phone (508) 368-5529
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0391310 | Medicaid | MA | |
| 042472266 | Other | THREE RIVERS | |
| 042472266008 | Other | TRICARE CHAMPUS | |
| NP3652 | Other | BLUE SHIELD HMO BLUE | |
| NP3652 | Other | BLUE SHIELD INDEMNITY | |
| NP3652 | Other | BLUE CARE ELECT | |
| AA635 | Other | HARVARD PILGRIM HEALTHCAR | |
| 0391310 | Other | MEDICAID WELFARE | |
| 042472266 | Other | PRIVATE HEALTHCARE SYSTEM | |
| 61996 | Other | FALLON COMMUNITY HEALTH P |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boston Emergency Physician Foundation, Inc. | Past | Accepting new patients | |
| Reliant Medical Group, Inc | Past | Accepting new patients | |
| Reliant Medical Group, Inc | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Boston, MA
- NPI 1427005859
-
- Physical Therapist
- Worcester, MA
- NPI 1295827962
-
- Family Medicine Physician
- Worcester, MA
- NPI 1720017528
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398643200000",
"number": "1891761946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 PLANTATION ST",
"address_2": "WOT 12TH FLOOR ATTN PHYSICIAN SERVICES",
"city": "WORCESTER",
"state": "MA",
"postal_code": "01605",
"telephone_number": "508-368-5529",
"fax_number": "508-368-5530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 PLANTATION ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "01605",
"telephone_number": "508-595-2505",
"fax_number": "508-854-0650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUFMAN",
"first_name": "R LISA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-28",
"last_updated": "2014-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "200050",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0391310",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THREE RIVERS",
"identifier": "042472266",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE CHAMPUS",
"identifier": "042472266008",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD HMO BLUE",
"identifier": "NP3652",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD INDEMNITY",
"identifier": "NP3652",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE ELECT",
"identifier": "NP3652",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM HEALTHCAR",
"identifier": "AA635",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID WELFARE",
"identifier": "0391310",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIVATE HEALTHCARE SYSTEM",
"identifier": "042472266",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON COMMUNITY HEALTH P",
"identifier": "61996",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.