NPIMap

Individual provider Active NPI

Michal Jakub Kubiak, M.D.

  • Hematology & Oncology Physician
  • McHenry, IL
National Provider Identifier
1144776360
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MED-PHYS-LIC-117889 Issued in MT
Practice address
4111 W. Lillian Street Apt. F
McHenry, IL 60050
Phone
(224) 828-0682
NPI assigned
Aug 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125069401 IL
Hematology & Oncology Physician 207RH0003X MED-PHYS-LIC-117889 MT Primary

Addresses

Primary practice location

4111 W. Lillian Street Apt. F
McHenry, IL 60050

Mailing address

4111 W Lillian St Apt F
McHenry, IL 60050-5394

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, ND2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230908000472 MT Practitioner - Hematology/Oncology 0547687626 Reassigns benefits to 1 organization
I20240126001291 ND Practitioner - Hematology/Oncology 0547687626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Billings ClinicGroup PAC ID 6002993516, shared by 7 NPIs, 814 clinicians

Practice addresses (Care Compare)

1301 15TH Ave W
Williston, ND 58801-3821
Phone (701) 774-7400

801 N 29TH St
Billings, MT 59101-0905
Phone (406) 238-2500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125069401ILMDInternal Medicine Physician
MED-PHYS-LIC-117889MTMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Billings Clinic Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
Billings Clinic Current Accepting new patients
Billings Clinic Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
Billings Clinic Hematology & Oncology CurrentSince Dec 12, 2023 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Billings Clinic Past Accepting new patients

Locations

801 N 29th St
Billings, MT 59101
Phone (406) 238-2210

2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290

1301 15th Ave W
Williston, ND 58801
Phone (701) 774-7400

Organizations & group practices 6

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1144776360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 W LILLIAN ST APT F",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600505394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 W. LILLIAN STREET APT. F",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "60050",
            "telephone_number": "224-828-0682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBIAK",
        "first_name": "MICHAL",
        "middle_name": "JAKUB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-28",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125069401",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MT",
            "license": "MED-PHYS-LIC-117889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

Verify at the official NPI Registry.