Individual provider Active NPI

David Cubito, PSY.D.

  • Psychologist
  • St Petersburg, FL
National Provider Identifier
1366533994
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY5620 Issued in FL
Practice address
5565 Dr Martin Luther King Jr St N
St Petersburg, FL 33703-1203
Phone
(727) 527-1969
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY5620 FL Primary

Addresses

Primary practice location

5565 Dr Martin Luther King Jr St N
St Petersburg, FL 33703-1203

Mailing address

1114 36TH Ave NE
St Petersburg, FL 33704-1616
Phone (727) 527-1969

Other identifiers 2

IdentifierTypeStateIssuer
768870900MedicaidFL
73061OtherFLBSFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050610000306 FL Practitioner - Clinical Psychologist 7618911611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

275 4TH St N
St Petersburg, FL 33701-3205
Phone (727) 527-1969

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY5620FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
David S Cubito PSYD PLC CurrentSince Aug 20, 2003 Accepting new patients

Locations

275 4th St N
St Petersburg, FL 33701
Phone (727) 527-1969

5565 Mlk Jr St N
St Petersburg, FL 33703
Phone (727) 577-1203

6540 4th St N
St Petersburg, FL 33702
Phone (727) 525-0155

Networks

  • Freedom Health HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206489600000",
    "number": "1366533994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 36TH AVE NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337041616",
            "telephone_number": "727-527-1969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5565 DR MARTIN LUTHER KING JR ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337031203",
            "telephone_number": "727-527-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUBITO",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2008-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY5620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "768870900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSFL",
            "identifier": "73061",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.