Individual provider Active NPI

Jeffrey Kupferman, LCSW

  • Clinical Social Worker
  • Hewlett, NY
National Provider Identifier
1962553297
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R019507-1 Issued in NY
Practice address
1234 W Broadway
Hewlett, NY 11557-1929
Phone
(516) 314-4634
NPI assigned
Jan 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R019507-1 NY Primary

Addresses

Primary practice location

1234 W Broadway
Hewlett, NY 11557-1929

Mailing address

611 E Beech St
Long Beach, NY 11561-3703
Phone (516) 432-6909

Other identifiers 2

IdentifierTypeStateIssuer
7401032OtherNYGHI PROVIDER ID NUMBER
080666OtherVALUEOPTIONS PROVIDER ID

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R019507-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962553297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E BEECH ST",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613703",
            "telephone_number": "516-432-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 W BROADWAY",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115571929",
            "telephone_number": "516-314-4634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPFERMAN",
        "first_name": "JEFFREY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R019507-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PROVIDER ID NUMBER",
            "identifier": "7401032",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS PROVIDER ID",
            "identifier": "080666",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hewlett, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.