Johanna Kubichek

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00407800 Issued in NJ

Practice address

456 Prospect Ave
West Orange, NJ 07052-4112

Phone

(973) 731-6767

NPI assigned

Sep 13, 2016

Last updated

May 12, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Josephs Medical Group PCGroup PAC ID 8628470325, 217 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph's University Medical Center Inc Hospital, Paterson, NJ, CCN 310019

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• St Josephs Medical Group PC

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1205425519
  Medicare reassignment Care Compare group
• St. Joseph's Healthcare, Inc.

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1497791297
  Medicare reassignment

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

• St Josephs University Medical Center Inc.

  • General Acute Care Hospital
  • Paterson, NJ
  • NPI 1669462420
  Care Compare affiliation

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1336697895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 W SAINT GEORGES AVE",
            "city": "LINDEN",
            "state": "NJ",
            "postal_code": "070365638",
            "telephone_number": "908-925-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 PROSPECT AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524112",
            "telephone_number": "973-731-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBICHEK",
        "first_name": "JOHANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-13",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00407800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Herms Krassner, MSW LCSW
• Elion J Krok, M.D.
• Jonathan Kronenberg, DPT
• Maya Rose Kruger, LCAT-P
• Krystite Care LLC
• Elizabeth A Kuehne, NP
• Elie Kuhne
• George Ralph Kuntz, MD
• Devendra Kurani, MD
• Jolly M Kuruvilla

• Medical Physician Assistant in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.