Individual provider Active NPI

Eric Kubik, FNP

  • Nurse Practitioner
  • Wisconsin Rapids, WI
National Provider Identifier
1174379432
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
15449-33 Issued in WI
Practice address
410 Dewey St
Wisconsin Rapids, WI 54494-4715
Phone
(717) 423-6060
NPI assigned
Apr 27, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 15449-33 WI Primary

Addresses

Primary practice location

410 Dewey St
Wisconsin Rapids, WI 54494-4715

Mailing address

36520 128TH St
Twin Lakes, WI 53181-9390
Phone (414) 349-4196

Other practice location 1

125 Hospital Dr
Watertown, WI 53098-3303
Phone (920) 261-4210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20240927000995 WI Practitioner - Nurse Practitioner 5395276646 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physician Associates of Wisconsin SCGroup PAC ID 3577865690, 20 clinicians
Swea Fort SCGroup PAC ID 0345774972, 51 clinicians

Practice addresses (Care Compare)

125 Hospital Dr
Watertown, WI 53098-3303
Phone (920) 261-4210

611 Sherman Ave E
Fort Atkinson, WI 53538-1960
Phone (920) 568-5475

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Sep 3, 2024 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. Current Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Sep 3, 2024 Accepting new patients
Swea Fort SC CurrentSince Oct 18, 2025 Accepting new patients
Emergency Physician Associates of Wisconsin SC Nurse Practitioner CurrentSince Dec 1, 2025 Accepting new patients
Southern Wisconsin Emergency Associates SC CurrentSince Sep 22, 2025 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210

420 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-7474

410 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-5257

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1714176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1174379432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36520 128TH ST",
            "city": "TWIN LAKES",
            "state": "WI",
            "postal_code": "531819390",
            "telephone_number": "414-349-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 DEWEY ST",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544944715",
            "telephone_number": "717-423-6060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "WI",
            "postal_code": "530983303",
            "country_code": "US",
            "telephone_number": "920-261-4210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUBIK",
        "first_name": "ERIC",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-27",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "15449-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wisconsin Rapids, WI

Sources for this page

Verify at the official NPI Registry.