Individual provider Active NPI

Jennifer Mait-Kaufman, M.D.

  • Pediatrics Physician
  • New Hyde Park, NY
National Provider Identifier
1891927216
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
253469 Issued in NY
Practice address
1991 Marcus Ave
New Hyde Park, NY 11042-2057
Phone
(516) 472-3650
NPI assigned
Aug 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 253469 NY Primary

Addresses

Primary practice location

1991 Marcus Ave
New Hyde Park, NY 11042-2057

Mailing address

1991 Marcus Ave
New Hyde Park, NY 11042-2057

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160418001133 NY Practitioner - Pediatric Medicine 9638477144 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Feb 17, 2016 Accepting new patients

Locations

52C Broadway
Brooklyn, NY 11249
Phone (718) 226-6888

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1991 Marcus Ave
Ste M100
New Hyde Park, NY 11042
Phone (516) 472-3650

1991 Marcus Ave
North New Hyde Park, NY 11042
Phone (516) 200-0025

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: jmaitkaufman218622@northwell.direct-ci.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1891927216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422057",
            "telephone_number": "516-472-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIT-KAUFMAN",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-18",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "253469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.