Individual provider Active NPI

Hayley Marie Kubacki, PA-C

  • Surgical Physician Assistant
  • Pittsburgh, PA
National Provider Identifier
1174091094
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MA063000 Issued in PA
Practice address
4815 Liberty Ave Ste 252
Pittsburgh, PA 15224-2156
Phone
(412) 235-5830
NPI assigned
Nov 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA063000 PA Primary

Addresses

Primary practice location

4815 Liberty Ave Ste 252
Pittsburgh, PA 15224-2156

Mailing address

4815 Liberty Ave Ste 252
Pittsburgh, PA 15224-2156

Other identifiers 1

IdentifierTypeStateIssuer
14417935OtherCAQH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hbarblock190490@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20211109000069 PA Practitioner - Physician Assistant 8426391723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic CurrentSince Oct 28, 2021 Accepting new patients
Allegheny Clinic CurrentSince Oct 28, 2021 Accepting new patients

Locations

4815 Liberty Ave
Ste 252
Pittsburgh, PA 15224
Phone (412) 235-5830

4815 Liberty Ave
Ste 425
Pittsburgh, PA 15224
Phone (412) 359-4352

4800 Friendship Ave
Pittsburgh, PA 15224
Phone (412) 359-3030

Interoperability endpoints

  • Direct secure messaging: hbarblock190490@direct.ahn.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1174091094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 LIBERTY AVE STE 252",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 LIBERTY AVE STE 252",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242156",
            "telephone_number": "412-235-5830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBACKI",
        "first_name": "HAYLEY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA063000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14417935",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hbarblock190490@direct.ahn.org",
            "affiliation": "N",
            "address_1": "4815 Liberty Ave Ste 252",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152242156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.