Tiffany Marie Kubis, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

6472 Issued in OH

Practice address

45 Manor Hill Dr
Suite 100
Canfield, OH 44406-1527

Phone

(330) 702-3937

NPI assigned

May 25, 2016

Last updated

May 25, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ahlquist Eye Care Professionals, LLC.Group PAC ID 9436175718, 2 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ahlquist Eye Care Professionals, LLC.

  • Optometrist
  • Canfield, OH
  • NPI 1104000520
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1154779692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BOARDMAN CANFIELD RD",
            "address_2": "APT 64B",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445128056",
            "telephone_number": "740-584-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MANOR HILL DR",
            "address_2": "SUITE 100",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444061527",
            "telephone_number": "330-702-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBIS",
        "first_name": "TIFFANY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-25",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Mark Koren, R.PH.
• Kassandra Sue Kornbau, DNP,PMHNP-BC,FNP-BC
• Eledath Unni Krishnan, MD
• Angela Catherine Krupka
• Cynthia Ann Kruzel-O'Keefe, LPCC-S
• Thomas Richard Kupec, PSY.D, LPCC
• Lakhani MD LLC
• Anne Lally, LPCC-S
• Karli Noelle Lash, BS, LSW
• Matthew S Leathers, PT, DPT

• Optometrist in Canfield, OH
• Providers in Canfield, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.