Individual provider Active NPI

Kevin Loeber, PA-C

  • Physician Assistant
  • Riverhead, NY
National Provider Identifier
1326832387
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
31 Main Rd
Riverhead, NY 11901-1953
Phone
(631) 727-6308
Fax
(631) 281-1420
NPI assigned
Apr 7, 2025
Last updated
Oct 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

31 Main Rd
Riverhead, NY 11901-1953

Mailing address

200 Park Ave
Florham Park, NJ 07932-1026

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251017000643 NY Practitioner - Physician Assistant 6103313606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peconic Bay Primary Medical CareGroup PAC ID 7113817602, 72 clinicians

Practice addresses (Care Compare)

34 Commerce Ave
Riverhead, NY 11901-3118
Phone (631) 727-1600

496 County Rd
111 BLDG B
Manorville, NY 11949-3386
Phone (631) 405-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peconic Bay Primary Medical Care CurrentSince Sep 1, 2025 Accepting new patients

Locations

496 County Road 111
Bldg B
Manorville, NY 11949
Phone (631) 405-3200

31 Main Rd
Ste 3
Riverhead, NY 11901
Phone (631) 405-3238

34 Commerce Ave
Riverhead, NY 11901
Phone (631) 591-3000

6144 Route 25A
Ste C
Wading River, NY 11792
Phone (631) 369-5000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1326832387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PARK AVE",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 MAIN RD",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119011953",
            "telephone_number": "631-727-6308",
            "fax_number": "631-281-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOEBER",
        "first_name": "KEVIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

Verify at the official NPI Registry.