Healthcare Provider Details

I. General information

NPI: 1356920391
Provider Name (Legal Business Name): NICHOLAS IAN KAUFMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 W ALASKA PL
DENVER CO
80219-2454
US

IV. Provider business mailing address

4320 W ALASKA PL
DENVER CO
80219-2454
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberDR.0069578
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTL.0008569
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0069578
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: