NPIMap

Individual provider Active NPI

Jeffrey Michael Kubiak, MD, PHD

  • Clinical Pathology/Laboratory Medicine Physician
  • New York, NY
National Provider Identifier
1184187627
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
313919 Issued in NY
Practice address
1300 York Ave # F-7
New York, NY 10065-4805
Phone
(215) 906-9559
NPI assigned
Apr 11, 2019
Last updated
Aug 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Microbiology Physician 207ZM0300X 73840 MN
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 313919 NY Primary

Addresses

Primary practice location

1300 York Ave # F-7
New York, NY 10065-4805

Mailing address

320 E 54TH St Apt 4C
New York, NY 10022-5043
Phone (215) 906-9559

Other practice location 1

420 Delaware St SE
Minneapolis, MN 55455-0341
Phone (612) 626-0622

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240815002248 NY Practitioner - Pathology 1850620162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Perelman School of Med at the University of Pennsylvania, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

170 William St
New York, NY 10038-2612
Phone (212) 312-5000

525 E 68TH St
New York, NY 10065-4870

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
313919NYMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Weill Medical College of Cornell Clinical Pathology/Laboratory Medicine Current Accepting new patients
Weill Medical College of Cornell CurrentSince Sep 1, 2024 Accepting new patients
Fairview Express Care CurrentSince Jun 1, 2023 Accepting new patients
Healtheast Medical Research Institute CurrentSince May 1, 2023 Accepting new patients
Healtheast Medical Research Insititue CurrentSince May 1, 2023 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Express Care CurrentSince Jun 1, 2023 Accepting new patients
Weill Medical College of Cornell CurrentSince Sep 1, 2024 Accepting new patients

Locations

420 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-5454

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0331

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1300 York Ave
#F7
New York, NY 10065
Phone (215) 906-9559

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

Organizations & group practices 9

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.

Hospital & facility affiliations 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1184187627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E 54TH ST APT 4C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225043",
            "telephone_number": "215-906-9559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 YORK AVE # F-7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654805",
            "telephone_number": "215-906-9559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Delaware St SE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554550341",
            "country_code": "US",
            "telephone_number": "612-626-0622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUBIAK",
        "first_name": "JEFFREY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-11",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZM0300X",
            "taxonomy_group": "",
            "desc": "Pathology, Medical Microbiology",
            "state": "MN",
            "license": "73840",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "NY",
            "license": "313919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.