Individual provider Active NPI

Saige Elyse Kubac, MD

  • Family Medicine Physician
  • Klamath Falls, OR
National Provider Identifier
1407317647
Registry record updated Sep 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD211405 Issued in OR
Practice address
2865 Daggett Ave
Klamath Falls, OR 97601-1106
Phone
(541) 882-6311
NPI assigned
Mar 29, 2019
Last updated
Sep 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X MD211405 OR Primary

Addresses

Primary practice location

2865 Daggett Ave
Klamath Falls, OR 97601-1106

Mailing address

1050 Sunset Beach Rd
Klamath Falls, OR 97601-1782
Phone (541) 218-3122

Other practice location 1

1664 N Virginia St
Reno, NV 89557-0001
Phone (775) 682-8646

Other practice location 2

2865 Daggett Ave
Klamath Falls, OR 97601-1106

Other practice location 3

2865 Daggett Ave
Klamath Falls, OR 97601-1106
Phone (541) 882-6311

Other practice location 4

2865 Daggett Ave
Klamath Falls, OR 97601-1106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20220929002481 OR Practitioner - Family Practice 6305279373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sky Lakes Medical Center IncGroup PAC ID 1052204096, 196 clinicians

Practice addresses (Care Compare)

2850 Daggett Ave
Klamath Falls, OR 97601-1107
Phone (541) 274-8610

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD211405ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sky Lakes Medical Center Inc CurrentSince Sep 9, 2022 Accepting new patients
Sky Lakes Medical Center Inc CurrentSince Sep 9, 2022 Accepting new patients

Locations

2850 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 274-8610

2865 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 833-6221

Organizations & group practices 2

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 2

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": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1407317647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 SUNSET BEACH RD",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011782",
            "telephone_number": "541-218-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-882-6311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1664 N Virginia St",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895570001",
            "country_code": "US",
            "telephone_number": "775-682-8646",
            "fax_number": "775-682-8610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2865 Daggett Ave",
            "address_purpose": "LOCATION",
            "city": "Klamath Falls",
            "state": "OR",
            "postal_code": "976011106",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2865 Daggett Ave",
            "address_purpose": "LOCATION",
            "city": "Klamath Falls",
            "state": "OR",
            "postal_code": "976011106",
            "country_code": "US",
            "telephone_number": "541-882-6311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2865 Daggett Ave",
            "address_purpose": "LOCATION",
            "city": "Klamath Falls",
            "state": "OR",
            "postal_code": "976011106",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUBAC",
        "first_name": "SAIGE",
        "middle_name": "ELYSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD211405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.