Brinsley Joallen Kubiak, MS, RDN, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86153070 Issued in MI

Practice address

343 W Wolf Point PLZ Unit 2502
Chicago, IL 60654-0105

Phone

(616) 402-7390

NPI assigned

Jul 24, 2023

Sex

Female

Sole proprietor

Yes

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 IL

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Revolution PTWL LLCGroup PAC ID 7719115617, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Revolution PTWL LLC

  dba Revolution Physical Therapy Weight Loss

  • Physical Therapist
  • Chicago, IL
  • NPI 1164766606

  Dietitian, Registered

  Medicare reassignment Care Compare group NPD
• Fay Nutrition

  • Registered Dietitian
  • San Francisco, CA
  • NPI 1104334465

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1457031551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 W WOLF POINT PLZ UNIT 2502",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606540105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 W WOLF POINT PLZ UNIT 2502",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606540105",
            "telephone_number": "616-402-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBIAK",
        "first_name": "BRINSLEY",
        "middle_name": "JOALLEN",
        "credential": "MS, RDN, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-24",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "86153070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Kubasak, PT, DPT
• Kube Psychological Services LLC
• Erin Rose Kube, PHD
• Nicole Taylor Kubera, MSW
• Justin Anthony Kubert
• Rachel Margaret Kubiak
• Lucille M. Kubica, R.N.
• Tiana Shevon Kubik
• Agata Daria Kubinska, LCSW
• Monica Kubit

• Registered Dietitian in Chicago, IL
• Providers in Chicago, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.