Matthew Kubasta, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

9501588 Issued in CA

Practice address

1420 Willow Pass Rd
Concord, CA 94520

Phone

(925) 646-5480

NPI assigned

Jan 8, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Helena Hospital 85 clinicians

Cep America - Psychiatry PC 93 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• John Muir Medical Center - Walnut Creek Campus Hospital, Walnut Creek, CA, CCN 050180
• John Muir Medical Center - Concord Campus Hospital, Concord, CA, CCN 050496
• Adventist Health St Helena Hospital, Saint Helena, CA, CCN 050013

Merit-based Incentive Payment System (MIPS)

Final score

85.91 of 100Reported as group

Quality

75.49

Promoting interoperability

94

Improvement activities

40

Cost

73.96

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Cep America - Psychiatry PC

  • Psychiatry Physician
  • Santa Maria, CA
  • NPI 1538757232

  CA

  Medicare reassignment Care Compare group NPD
• St. Helena Hospital

  • General Acute Care Hospital
  • Saint Helena, CA
  • NPI 1720078082

  CA

  Medicare reassignment Care Compare group NPD
• St. Helena Hospital

  • Psychiatric Hospital
  • Vallejo, CA
  • NPI 1851381990
  Care Compare group NPD
• Cep America - Psychiatry PC

  • Psychiatry Physician
  • Indio, CA
  • NPI 1144195926
  NPD
• Cep America - Psychiatry PC

  • Psychiatry Physician
  • Concord, CA
  • NPI 1669977682
  NPD
• Contra Costa County

  • Adult Mental Health Clinic/Center
  • Concord, CA
  • NPI 1023188489
  NPD

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

• John Muir Health

  • General Acute Care Hospital
  • Walnut Creek, CA
  • NPI 1740215219

  Hospital

  Care Compare affiliation
• John Muir Health

  • General Acute Care Hospital
  • Concord, CA
  • NPI 1801821376

  Hospital

  Care Compare affiliation
• St. Helena Hospital

  • General Acute Care Hospital
  • Saint Helena, CA
  • NPI 1720078082

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1063985455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 AVOCADO PL",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945131908",
            "telephone_number": "510-760-4803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 WILLOW PASS RD",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "94520",
            "telephone_number": "925-646-5480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "747 52nd St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "94609",
            "country_code": "US",
            "telephone_number": "510-428-3571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "747 52nd St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "94609",
            "country_code": "US",
            "telephone_number": "510-428-3571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUBASTA",
        "first_name": "MATTHEW",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-08",
        "last_updated": "2021-12-20",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "9501588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Eileen Kroll, M.D.
• Jennifer L Kroninger
• Kamla Krouch
• Mikayla Kruse
• Hsiu-Tsun Ku
• Sophia Autumn Kuhlman
• Olukemi A Kuku, DNP, PMHNP
• Ramandeep Kular, PH.D.
• Makara Magret Kulilishika
• Jillian Kulinski

• All providers in Concord, CA
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.

Verify at the official NPI Registry.