Provider Demographics
NPI:1013989383
Name:KAUFMAN, ANDREW B (M D)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:B
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 W 119TH ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3721
Mailing Address - Country:US
Mailing Address - Phone:888-942-2774
Mailing Address - Fax:866-807-1897
Practice Address - Street 1:5701 W 119TH ST
Practice Address - Street 2:SUITE 215
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-3721
Practice Address - Country:US
Practice Address - Phone:888-942-2774
Practice Address - Fax:866-807-1897
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4609174400000X, 207T00000X
KS04-15463174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100001570EMedicaid
KS100001570AMedicaid
KS100001570FMedicaid
MO200785707Medicaid
MO1013989383Medicaid
KS100001570 CMedicaid
KS100001570DMedicaid
KS100001570EMedicaid
KSKA1133002Medicare PIN
MO2792489Medicare PIN
MO200785707Medicaid
KSP00655714Medicare PIN
MOMA1110002Medicare PIN