Active NPI
Richard Joseph Kubicka, M.D.
- Vascular Surgery Physician
- Princeton, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 46028
- Practice address
- 919 Northland Dr
Princeton, MN 55371-2172 - Phone
- (763) 389-3344
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 46028 | MN | Primary |
| Specialist | 174400000X | 46028 | MN | |
| Surgery Physician | 208600000X | 46028 | MN |
Addresses
Primary practice location
919 Northland Dr
Princeton, MN 55371-2172
Mailing address
1700 University Ave W
Saint Paul, MN 55104-3727
Other practice location 1
290 Main St NW
Suite 100
Elk River, MN 55330-1270
Phone (763) 241-0373
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 260491400 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- Rutgers New Jersey Medical School, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
14500 99TH Ave N
Suite 100
Maple Grove, MN 55369-4738
Phone (763) 898-1000
Hospital & facility affiliations
- Fairview Northland Regional Hospital
- Fairview Lakes Health Services
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.63 of 100
- Quality
- 75.41
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.75
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 25 |
| Hernia repair (minimally invasive) | 1-10 |
| Mastectomy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 11 |
| Varicose vein removal | 1-10 |
| Removal of tissue | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46028 | MN | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Range Regional Health Services | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Range Regional Health Services | Current | Accepting new patients | |
| Range Regional Health Services | Current | Accepting new patients |
Locations
14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400
1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860
6405 France Ave S
Ste W320
Edina, MN 55435
Phone (952) 915-8626
6405 France Ave S
Ste 440
Edina, MN 55435
Phone (952) 927-7004
290 Main St NW
Ste 100
Elk River, MN 55330
Phone (763) 241-0373
3605 Mayfair Ave
Hibbing, MN 55746
Phone (218) 262-3441
750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441
12680 Arbor Lakes Pkwy N
Maple Grove, MN 55369
Phone (763) 488-8346
14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000
6341 University Ave NE
Minneapolis, MN 55432
Phone (763) 427-9980
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
420 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-6483
400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203
10000 Zane Ave N
Minneapolis, MN 55443
Phone (763) 528-6999
402 E Platt Ave
Nashwauk, MN 55769
Phone (218) 885-2858
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
919 Northland Dr
Princeton, MN 55371
Phone (763) 389-3344
1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740
Interoperability endpoints
- rkubicka10397@fairview.direct-ci.com
Organizations & group practices 12
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.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1053952606
-
- Primary Care Clinic/Center
- Minneapolis, MN
- NPI 1346432218
-
- Clinic/Center
- Hibbing, MN
- NPI 1669569265
-
- Emergency Medicine Physician
- Minneapolis, MN
- NPI 1811077175
-
- Primary Care Clinic/Center
- Saint Paul, MN
- NPI 1396552147
-
- General Practice Physician
- Edina, MN
- NPI 1831707207
-
- Eyewear Supplier
- Fridley, MN
- NPI 1942482740
-
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1013994359
-
- Land Ambulance
- Saint Paul, MN
- NPI 1710212485
-
- Hospitalist Physician
- Edina, MN
- NPI 1770663031
-
- General Acute Care Hospital
- Hibbing, MN
- NPI 1356321699
-
- Durable Medical Equipment & Medical Supplies
- International Falls, MN
- NPI 1710954821
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Princeton, MN
- NPI 1841351749
-
- General Acute Care Hospital
- Princeton, MN
- NPI 1922085299
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723161600000",
"number": "1255369989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 UNIVERSITY AVE W",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551043727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "919 NORTHLAND DR",
"city": "PRINCETON",
"state": "MN",
"postal_code": "553712172",
"telephone_number": "763-389-3344"
}
],
"practiceLocations": [
{
"address_1": "290 Main St NW",
"address_2": "Suite 100",
"address_purpose": "LOCATION",
"city": "Elk River",
"state": "MN",
"postal_code": "553301270",
"country_code": "US",
"telephone_number": "763-241-0373",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KUBICKA",
"first_name": "RICHARD",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2024-08-09",
"certification_date": "2024-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "MN",
"license": "46028",
"primary": true
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MN",
"license": "46028",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MN",
"license": "46028",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "260491400",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Princeton, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.