Andrew Stube, DPT, OCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305208165 Issued in VA

Practice address

4812 Kyloe LN
Moseley, VA 23120-1242

Phone

(804) 248-1617

Fax

(804) 533-0527

NPI assigned

Aug 2, 2013

Last updated

Jan 2, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Functional Pathways Preferred of Tennessee LLCGroup PAC ID 2860649654, 194 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Functional Pathways Preferred of Tennessee LLC

  • Physical Therapist
  • Knoxville, TN
  • NPI 1841561446

  VA

  Medicare reassignment Care Compare group NPD
• Virginia Luna Care Physical Therapy LLC

  • Physical Therapist
  • Fairfax, VA
  • NPI 1235720848

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1053743864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1769",
            "city": "MIDDLEBURG",
            "state": "VA",
            "postal_code": "201181769",
            "telephone_number": "540-687-8181",
            "fax_number": "540-687-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4812 KYLOE LN",
            "city": "MOSELEY",
            "state": "VA",
            "postal_code": "231201242",
            "telephone_number": "804-248-1617",
            "fax_number": "804-533-0527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUBE",
        "first_name": "ANDREW",
        "credential": "DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-02",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305208165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Seamster, LPTA
• Deepak Sharma, PT
• Kristine Susanne Simbulan, NP
• Steadfast Rehabilitation, Inc
• Steadfast Rehabilitation, Inc
• Sarah Taylor, LCSW
• Marcus Thomas
• Gina White Thompson
• Remy Jones Thompson, PH.D.
• Monica Tremaglio

• Physical Therapist in Moseley, VA
• Providers in Moseley, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.