Active NPI
Andrew Kubisch, PA
- Physician Assistant
- Neenah, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 4769
- Practice address
- 333 N Green Bay Rd
Neenah, WI 54956-1954 - Phone
- (920) 729-6088
- NPI assigned
- Apr 21, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 4769 | WI | Primary |
Addresses
Primary practice location
333 N Green Bay Rd
Neenah, WI 54956-1954
Mailing address
3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 729-6088
Other practice location 1
600 N Westhaven Dr
Oshkosh, WI 54904-6926
Phone (920) 237-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3 Neenah Ctr
Neenah, WI 54956-3070
333 N Green Bay Rd
Neenah, WI 54956-1954
Phone (920) 720-2300
3925 N Gateway Dr
Appleton, WI 54913-7863
Phone (820) 702-6477
4480 W Spencer St
Appleton, WI 54915
Phone (920) 738-4800
600 N Westhaven Dr
Oshkosh, WI 54904-6926
Phone (920) 725-0077
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thedacare Medical Center - Berlin, Inc. | Past | Accepting new patients |
Interoperability endpoints
- akubisch277320@direct.thedacare.org
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- New London, WI
- NPI 1376656959
-
- Critical Access Hospital
- Berlin, WI
- NPI 1760413777
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Neenah, WI
- NPI 1023472842
-
- General Acute Care Hospital
- Menasha, WI
- NPI 1720434806
-
- General Acute Care Hospital
- Neenah, WI
- NPI 1518993880
-
- General Acute Care Hospital
- Oshkosh, WI
- NPI 1861943409
-
- General Acute Care Hospital
- Oshkosh, WI
- NPI 1679937494
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659398400000",
"number": "1003479494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 NEENAH CTR",
"city": "NEENAH",
"state": "WI",
"postal_code": "549563070",
"telephone_number": "920-729-6088",
"fax_number": "920-729-6484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 N GREEN BAY RD",
"city": "NEENAH",
"state": "WI",
"postal_code": "549561954",
"telephone_number": "920-729-6088"
}
],
"practiceLocations": [
{
"address_1": "600 N Westhaven Dr",
"address_purpose": "LOCATION",
"city": "Oshkosh",
"state": "WI",
"postal_code": "549046926",
"country_code": "US",
"telephone_number": "920-237-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KUBISCH",
"first_name": "ANDREW",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-21",
"last_updated": "2022-08-02",
"certification_date": "2022-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "4769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Neenah, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.