Tiffany Marie Kubis, O.D.
Individual provider Active NPI Optometrist · Canfield, OH
NPI 1154779692 · NPPES record last updated May 25, 2016
Key facts
- NPI
- 1154779692
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 6472 (OH)
- Practice address
- 45 Manor Hill Dr
Suite 100
Canfield, OH 44406-1527 - Phone
- (330) 702-3937
- NPI assigned
- May 25, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ahlquist Eye Care Professionals, LLC.
Practice addresses (Care Compare)
45 Manor Hill Dr
Suite 100
Canfield, OH 44406-1538
Phone (330) 702-3937
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170510002462 | OH | Practitioner - Optometry | 1153608633 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ahlquist Eye Care Professionals, LLC. | Optometrist | Current |
Accepting new patients |
Locations
45 Manor Hill Dr
Ste 100
Canfield, OH 44406
Phone (330) 702-3931
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 6472 | OH | Yes |
Addresses
Primary practice location
45 Manor Hill Dr
Suite 100
Canfield, OH 44406-1527
Mailing address
1100 Boardman Canfield Rd
Apt 64B
Boardman, OH 44512-8056
Phone (740) 584-1588
Other providers in Canfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.