Individual provider Active NPI

Todd M Kubesh, CRNA

  • Certified Registered Nurse Anesthetist
  • Johnson City, NY
National Provider Identifier
1063970580
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
717023-1 Issued in NY
Practice address
57 N Harrison St
Johnson City, NY 13790-1476
Phone
(607) 763-6000
NPI assigned
Mar 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 717023-1 NY Primary

Addresses

Primary practice location

57 N Harrison St
Johnson City, NY 13790-1476

Mailing address

156 Corliss Ave Apt 107
Johnson City, NY 13790-2071
Phone (607) 763-6735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190403001355 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587905443 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Health Services Hospitals, Inc.Group PAC ID 5193610533, 471 clinicians
Chenango Memorial Hospital IncGroup PAC ID 7517853633, 108 clinicians

Practice addresses (Care Compare)

10 -24 Mitchell Ave
Binghamton, NY 13903-1617
Phone (607) 762-3131

179 N Broad St
Norwich, NY 13815-1019
Phone (607) 337-4111

33 -57 Harrison St
Johnson City, NY 13790-2107
Phone (607) 763-6101

54 Main St
Candor, NY 13743-1619
Phone (607) 659-7272

Hospital & facility affiliations

  • United Health Services Hospitals, Inc Hospital, Binghamton, NY, CCN 330394
  • Chenango Memorial Hospital Hospital, Norwich, NY, CCN 330033

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
86.74
Promoting interoperability
99
Improvement activities
40
Cost
70.09

Merit-based Incentive Payment System (MIPS)

Final score
93.4 of 100Reported as group
Quality
86.36
Promoting interoperability
99
Improvement activities
40
Cost
79.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
717023-1NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Chenango Memorial Hospital Inc CurrentSince Jul 1, 2023 Accepting new patients
Chenango Memorial Hospital Inc CurrentSince Jul 1, 2023 Accepting new patients
United Health Services Hospitals, Inc. CurrentSince Dec 25, 2019 Accepting new patients
Chenango Memorial Hospital, Inc. Past Accepting new patients

Locations

33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156

179 N Broad St
Norwich, NY 13815
Phone (607) 337-4111

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1063970580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 CORLISS AVE APT 107",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902071",
            "telephone_number": "607-763-6735",
            "fax_number": "607-763-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 N HARRISON ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901476",
            "telephone_number": "607-763-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBESH",
        "first_name": "TODD",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-04",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "717023-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; 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.