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MR. DERRICK LEIGH KAUFMAN JR. LICDC
NPI 1073173498
Counselor - Addiction (Substance Use Disorder) in Dayton, OH

Active since June 18, 2019PECOS Enrolled
4977 NORTHCUTT PL, DAYTON, OH 45414(937) 387-6395 Get Directions Write a Review

NPPES record last updated: August 30, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 30, 2023, Sep 10, 2019, Jun 18, 2019 (3 updates tracked since 2019).

About Mr. Derrick Leigh Kaufman Jr. Licdc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. DERRICK LEIGH KAUFMAN JR. LICDC (NPI 1073173498) is an individual addiction (substance use disorder) provider in Dayton, Ohio, licensed in Ohio (LICDC162158) and active in the NPI registry since June 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073173498
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. DERRICK LEIGH KAUFMAN JR.Credential: LICDC
Location Address4977 NORTHCUTT PLDayton, OH 45414-3839
Mailing Address328 Orchard PlWintersville, OH 43953-3942
Phone(937) 387-6395
Sole ProprietorNo
Enumeration DateJune 18, 2019
Last NPPES UpdateAugust 30, 20233 updates tracked since enumeration
NPPES CertifiedAugust 30, 2023
✔ NPI 1073173498 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in OH · LICDC162158
4977 NORTHCUTT PL, Dayton, OH 45414
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Oscar Health Insurance, Oscar Insurance Corporation of Ohio.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Derrick Leigh Kaufman Jr. Licdc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Derrick Kaufman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Lets In Mental Health & Recovery LLC
45 mi
Community/Behavioral Health
7162 READING RD STE 720
Cincinnati, OH 45237
  • Reassigned Medicare billing, Ohio enrollment
  • 7 clinicians in this Medicare group
NPI 1033947650 (419) 699-0257

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MARSHA T RUSSELL CDCA
Counselor (Addiction (Substance Use Disorder))
4977 NORTHCUTT PL
DAYTON, OH 45414
Montgomery County (937) 387-6395
QUANICE LOCKE LCDCII
Counselor (Addiction (Substance Use Disorder))
4977 NORTHCUTT PL
DAYTON, OH 45414
Montgomery County (937) 450-7790
JEWELIA ELLIS RN
Registered Nurse (Addiction (Substance Use Disorder))
4977 NORTHCUTT PL
DAYTON, OH 45414
Montgomery County (800) 829-5461
BETHANY DAWN GIBSON
Counselor (Addiction (Substance Use Disorder))
4977 NORTHCUTT PL
DAYTON, OH 45414
Montgomery County (937) 387-6395
MRS. SEMAJA BRENT
Counselor (Addiction (Substance Use Disorder))
4977 NORTHCUTT PL
DAYTON, OH 45414
Montgomery County (937) 387-6395
JILL GINTER CDCA
Counselor (Addiction (Substance Use Disorder))
4977 NORTHCUTT PL
DAYTON, OH 45414
Montgomery County (937) 387-6395
PATRICIA CLARK CDCA
Counselor (Addiction (Substance Use Disorder))
4977 NORTHCUTT PL
DAYTON, OH 45414
Montgomery County (800) 829-5461
BLAINE ROWE PEER SUPPORT
Peer Specialist
4977 NORTHCUTT PL
DAYTON, OH 45414
Montgomery County (800) 829-5461

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derrick Kaufman's NPI number?

The NPI number for Derrick Kaufman is 1073173498. It was assigned to this individual provider in the NPPES registry on June 18, 2019.

Where is Derrick Kaufman located?

Derrick Kaufman practices at 4977 Northcutt Pl, Dayton, OH 45414. The listed phone number is (937) 387-6395.

What is Derrick Kaufman's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Derrick Kaufman enrolled in Medicare?

Yes. Derrick Kaufman is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Derrick Kaufman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Derrick Kaufman reassigns Medicare benefits to Lets In Mental Health & Recovery LLC (Cincinnati, OH). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Derrick Kaufman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Derrick Kaufman accept?

Health plans from CareSource, Oscar Health Insurance and Oscar Insurance Corporation of Ohio list Derrick Kaufman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Derrick Kaufman was last updated on August 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.