Individual provider Active NPI

Anthony F Kubina, LCP

  • Psychologist
  • Manhattan, KS
National Provider Identifier
1215206172
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1236 Issued in KS
Practice address
222 N 6TH St
Manhattan, KS 66502-6057
Phone
(785) 565-2962
NPI assigned
Dec 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1236 KS Primary

Addresses

Primary practice location

222 N 6TH St
Manhattan, KS 66502-6057

Mailing address

1133 College Ave Ste A213
Manhattan, KS 66502-2781
Phone (785) 410-6577

Other identifiers 1

IdentifierTypeStateIssuer
201111910AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240320000869 KS Practitioner - Clinical Psychologist 5496192916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Freedom Behavioral Health Solutions LLCGroup PAC ID 3577909431, 13 clinicians

Practice addresses (Care Compare)

1133 College Ave
Suite E110
Manhattan, KS 66502-2813
Phone (785) 775-0221

1133 College Ave BLD E
Suite 110
Manhattan, KS 66502-2781

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Freedom Behavioral Health Solutions, LLC CurrentSince Feb 14, 2024 Accepting new patients

Locations

1133 College Ave
Ste A213
Manhattan, KS 66502
Phone (785) 587-1825

1133 College Ave
Ste E110
Manhattan, KS 66502
Phone (785) 537-2651

Interoperability endpoints

  • Direct secure messaging: anthony.kubina.1@20807.direct.athenahealth.com

Organizations & group practices 1

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": "1324512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1215206172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 COLLEGE AVE STE A213",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665022781",
            "telephone_number": "785-410-6577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N 6TH ST",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665026057",
            "telephone_number": "785-565-2962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBINA",
        "first_name": "ANTHONY",
        "middle_name": "F",
        "credential": "LCP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-22",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "1236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201111910A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan, KS

Sources for this page

Verify at the official NPI Registry.