NPIMap

Individual provider Active NPI

Brian Keith Cubbage, MD

  • Family Medicine Physician
  • White Stone, VA
National Provider Identifier
1013904168
Registry record updated Oct 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101232462 Issued in VA
Practice address
30 Shady LN
White Stone, VA 22578-2601
Phone
(804) 435-3133
Fax
(804) 435-1311
NPI assigned
Oct 4, 2005
Last updated
Oct 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101232462 VA Primary

Addresses

Primary practice location

30 Shady LN
White Stone, VA 22578-2601

Mailing address

856 J Clyde Morris Blvd
Ste a
Newport News, VA 23601-1318

Other identifiers 1

IdentifierTypeStateIssuer
1013904168MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080527000164 VA Practitioner - Family Practice 3274602693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Virginia School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rappahannock Westminster-Canterbury, Inc.Group PAC ID 6103090345, shared by 3 NPIs, 13 clinicians
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

132 Lancaster Dr
Irvington, VA 22480-9740
Phone (804) 438-4000

30 Shady LN
White Stone, VA 22578-2601
Phone (804) 435-3133

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.91 of 100Reported as apm
Quality
92.86
Promoting interoperability
94.93
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions39
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc CurrentSince Jul 1, 2008 Accepting new patients
Riverside Physician Services Inc Current Accepting new patients
Riverside Physician Services Inc CurrentSince Jul 1, 2008 Accepting new patients
Riverside Physician Services Inc Family Medicine Past Accepting new patients

Locations

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

Interoperability endpoints

  • Direct secure messaging: bcubbage12359@direct.rivhs.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380844800000",
    "number": "1013904168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD",
            "address_2": "STE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 SHADY LN",
            "city": "WHITE STONE",
            "state": "VA",
            "postal_code": "225782601",
            "telephone_number": "804-435-3133",
            "fax_number": "804-435-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUBBAGE",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2013-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101232462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013904168",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Stone, VA

Sources for this page

Verify at the official NPI Registry.