Organization Active NPI

Richard T Kubiniec MD PS

  • Obstetrics & Gynecology Physician
  • Vancouver, WA
National Provider Identifier
1336318088
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD00034433 Issued in WA
Legal business name
RICHARD T KUBINIEC MD PS
Practice address
11801 NE 65TH St
#A
Vancouver, WA 98662-5552
Phone
(360) 892-0208
Fax
(360) 892-9081
NPI assigned
Feb 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Authorized official

Name
Richard T Kubiniec, MD
Title
President/Owner
Phone
(360) 892-0208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X MD00034433 WA Primary

Addresses

Primary practice location

11801 NE 65TH St
#A
Vancouver, WA 98662-5552

Mailing address

PO Box 820523
Vancouver, WA 98682-0011
Phone (360) 892-0208

Other identifiers 2

IdentifierTypeStateIssuer
1118116MedicaidWA
227404MedicaidOR

National Provider Directory

National Provider Directory

Locations

11801 NE 65th St
#A
Vancouver, WA 98662
Phone (360) 892-0208

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1336318088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820523",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986820011",
            "telephone_number": "360-892-0208",
            "fax_number": "360-892-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 NE 65TH ST",
            "address_2": "#A",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986625552",
            "telephone_number": "360-892-0208",
            "fax_number": "360-892-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD T KUBINIEC MD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "KUBINIEC",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "360-892-0208",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD00034433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1118116",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227404",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.