Individual provider Active NPI

Richard A Kube II, MD

  • Specialist
  • Peoria, IL
National Provider Identifier
1386625374
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036-112907 Issued in IL
Practice address
7620 N. University
Ste. 104
Peoria, IL 61614
Phone
(309) 691-7774
NPI assigned
Nov 8, 2005
Last updated
Nov 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036-112907 IL Primary

Addresses

Primary practice location

7620 N. University
Ste. 104
Peoria, IL 61614

Mailing address

P.O. Box 5173
Peoria, IL 61601-5173

Other identifiers 1

IdentifierTypeStateIssuer
036112907MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060828000218 IL Practitioner - Orthopedic Surgery 4981642873

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Saint Louis University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7620 N University St
Suite 104
Peoria, IL 61614-8300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-112907ILMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association Past Accepting new patients
Spine Surgery, PSC Past Accepting new patients
Midwest Orthopaedic Center S C Specialist Past Accepting new patients
Prairie Spine & Pain Institute of Southern Illinois, LLC PastSince May 13, 2011 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rkubemd389558@carlehiedirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1386625374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 5173",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616015173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7620 N. UNIVERSITY",
            "address_2": "STE. 104",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-691-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBE",
        "first_name": "RICHARD",
        "middle_name": "A",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-112907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112907",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.