Basic Information
| Provider Information | |||||||||
| NPI: | 1598846701 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAUFMAN | ||||||||
| FirstName: | JILL | ||||||||
| MiddleName: | RAE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 785 5TH AVENUE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7172174217 | ||||||||
| Practice Location | |||||||||
| Address1: | 112 NORTH SEVENTH STREET | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172673000 | ||||||||
| FaxNumber: | 7172174217 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2006 | ||||||||
| LastUpdateDate: | 05/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | ME80257 | FL | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | MD433468 | PA | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207L00000X | MD433468 | PA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | G920-0078/85XWCU | 01 | PA | CAREFIRST | OTHER | 050088870 | 01 | FL | RAILROAD MEDICARE | OTHER | 050514 | 01 | PA | MEDICARE GROUP # | OTHER | 25-1716306 | 01 | PA | FIRST HEALTH | OTHER | BF1155313 | 01 | DEA | OTHER | 25-1716306 | 01 | PA | INTERGROUP | OTHER | KA2011652 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | MD433468 | 01 | PA | MEDICAL LICENSE | OTHER | PEARL | 01 | PA | HEALTH AMERICA | OTHER | 1569287 | 01 | PA | GATEWAY | OTHER | 25-1716306 | 01 | PA | DEVON | OTHER | 50077192 | 01 | PA | CAPITAL BLUECROSS | OTHER | 7996547 | 01 | PA | AETNA NON-HMO | OTHER | P00458416 | 01 | PA | RAILROAD MEDICARE | OTHER | 1835259 | 01 | PA | AETNA HMO | OTHER | 25-1716306 | 01 | PA | SOUTH CENTRAL PREFERRED | OTHER | 102091286 0001 | 05 | PA | MEDICAID | 120420418 | 01 | PA | DEPT OF LABOR | OTHER | 2183091 | 01 | PA | MAMSI | OTHER | 240951 | 01 | PA | UNISON | OTHER | 25-1716306 | 01 | PA | INFORMED | OTHER | 25-1716306 | 01 | PA | HEALTHNET/TRICARE | OTHER | 25-1716306 | 01 | PA | MULTIPLAN/PHCS | OTHER | 58773 | 01 | FL | BLUE CROSS BLUE SHIELD | OTHER |