Individual provider Active NPI

Daniel Hubicki, M.D.

  • General Practice Physician
  • Ballston Lake, NY
National Provider Identifier
1144281809
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
221678-1 Issued in NY
Practice address
112 Charlton Rd
Ballston Lake, NY 12019-2547
Phone
(518) 399-7723
Fax
(518) 399-6428
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 221678-1 NY Primary

Addresses

Primary practice location

112 Charlton Rd
Ballston Lake, NY 12019-2547

Mailing address

112 Charlton Rd
Ballston Lake, NY 12019-2547
Phone (518) 399-7723

Other identifiers 1

IdentifierTypeStateIssuer
02171997MedicaidNY

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 Medicine

State licenses

LicenseStateTypeSpecialty
221678-1NYMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1144281809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 CHARLTON RD",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120192547",
            "telephone_number": "518-399-7723",
            "fax_number": "518-399-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 CHARLTON RD",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120192547",
            "telephone_number": "518-399-7723",
            "fax_number": "518-399-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBICKI",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "221678-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02171997",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballston Lake, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.