Individual provider Active NPI

Tia McCubbin

  • Licensed Practical Nurse
  • East Syracuse, NY
National Provider Identifier
1265340624
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
34292601 Issued in NY
Practice address
506 W Yates St Apt 2
East Syracuse, NY 13057-2128
Phone
(315) 664-6114
NPI assigned
Aug 28, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 34292601 NY Primary

Addresses

Primary practice location

506 W Yates St Apt 2
East Syracuse, NY 13057-2128

Mailing address

506 W Yates St Apt 2
East Syracuse, NY 13057-2128
Phone (315) 664-6114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1787875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1265340624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 W YATES ST APT 2",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130572128",
            "telephone_number": "315-664-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 W YATES ST APT 2",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130572128",
            "telephone_number": "315-664-6114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCUBBIN",
        "first_name": "TIA",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-28",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "34292601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.