Stacey Amber Kubovec, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

42481 Issued in OK

Practice address

4444 E 41St St
Tulsa, OK 74135-2527

Phone

(918) 619-4400

Fax

(918) 619-4960

NPI assigned

Apr 3, 2017

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

General Surgery

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Creek Nation Hospital and ClinicsGroup PAC ID 5698786226, 364 clinicians

Board of Regents of the University of Oklahoma Ou Physicians TulsaGroup PAC ID 5395645329, 83 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114
• Council Oak Comprehensive Healthcare Hospital, Tulsa, OK, CCN 370244

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Board of Regents of the University of Oklahoma Ou Physicians Tulsa

  • Multi-Specialty Clinic/Center
  • Tulsa, OK
  • NPI 1154385730
  Medicare reassignment Care Compare group NPD
• Creek Nation Hospital & Clinics

  dba Creek Nation Community Hospital

  • Family Medicine Physician
  • Okemah, OK
  • NPI 1467053173

  TX

  Medicare reassignment Care Compare group NPD
• Creek Nation Hospital & Clinics

  dba Creek Nation Health System

  • Clinic/Center
  • Muskogee, OK
  • NPI 1366593923
  Medicare reassignment NPD
• Creek Nation Hospital & Clinics

  dba Council Oak South

  • Clinic/Center
  • Tulsa, OK
  • NPI 1699343913
  NPD
• Creek Nation Hospital & Clinics

  dba Muscogee Healing and Recovery Center

  • Clinic/Center
  • Muskogee, OK
  • NPI 1922873611
  NPD
• Deaconess Memorial Medical Center Inc

  dba Memorial Healthcare of Huntingburg

  • Emergency Medicine Physician
  • Huntingburg, IN
  • NPI 1114120128
  NPD
• St John Medical Center Inc

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1154417368
  NPD (past)
• Indiana Clinic-Neurology, LLC

  • Neurology Physician
  • Indianapolis, IN
  • NPI 1578792271
  NPD (past)

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

• St John Medical Center Inc

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1154417368
  Care Compare affiliation
• St John Medical Center Inc

  • Rehabilitation Hospital Unit
  • Tulsa, OK
  • NPI 1578656161
  Care Compare affiliation

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1245762673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268838",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731268838",
            "telephone_number": "918-634-7500",
            "fax_number": "918-634-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352527",
            "telephone_number": "918-619-4400",
            "fax_number": "918-619-4960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBOVEC",
        "first_name": "STACEY",
        "middle_name": "AMBER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "42481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201220420A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna J Krutka, M.D.
• KRW Holdings, LLC
• KS Billco LLC
• Carly Ann Dykstra Kubat, M.D.
• Michael Kubelka, D.D.S., M.S.
• Ella Kuchmiy, DO
• Abhigna Reddy Kudumula, MD
• Pang Leilani Kue, FNP-C
• Cadence Jaye Kueker
• Gary L. Kuenning, D.D.S.

• Surgery Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; 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.