Individual provider Active NPI

Jason Kubik, PHARMD

  • Pharmacist
  • Clifton Park, NY
National Provider Identifier
1013461565
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20 058240 Issued in NY
Practice address
3D Fulham Rd
Clifton Park, NY 12065-6323
Phone
(518) 368-9801
NPI assigned
Aug 12, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20 058240 NY Primary

Addresses

Primary practice location

3D Fulham Rd
Clifton Park, NY 12065-6323

Mailing address

3D Fulham Rd
Clifton Park, NY 12065-6323
Phone (518) 368-9801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
20 058240NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1013461565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3D FULHAM RD",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120656323",
            "telephone_number": "518-368-9801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3D FULHAM RD",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120656323",
            "telephone_number": "518-368-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBIK",
        "first_name": "JASON",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-12",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "20 058240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.