NPIMap

Individual provider Active NPI

Frederick W Cubin III, M.D.

  • Diagnostic Radiology Physician
  • Casper, WY
National Provider Identifier
1457301004
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
8400A Issued in WY
Practice address
419 S Washington St
Suite 101
Casper, WY 82601-2951
Phone
(307) 265-1620
Fax
(307) 237-1074
NPI assigned
May 12, 2006
Last updated
Nov 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 8400A WY Primary
Vascular & Interventional Radiology Physician 2085R0204X 8400-A WY

Addresses

Primary practice location

419 S Washington St
Suite 101
Casper, WY 82601-2951

Mailing address

419 S Washington St
Suite 101
Casper, WY 82601-2951
Phone (307) 265-1620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, NE2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101018001204 WY Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 1658564067 Reassigns benefits to 3 organizations
I20240601000431 NE Practitioner - Diagnostic Radiology 1658564067 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of Washington School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Casper Medical Imaging PCGroup PAC ID 8224010871, 25 clinicians
Outpatient Radiology LLCGroup PAC ID 8628051596, 13 clinicians

Practice addresses (Care Compare)

1233 E 2ND St
Casper, WY 82601-2926
Phone (307) 265-1620

419 S Washington St
Suite 101
Casper, WY 82601-2951
Phone (307) 265-1620

820 W 42ND St
Suite 1500
Scottsbluff, NE 69361-5017
Phone (307) 265-1620

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8400AWYMDDiagnostic Radiology Physician
8400-AWYMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Outpatient Radiology LLC Diagnostic Radiology CurrentSince Mar 21, 2015 Accepting new patients
Campbell County Hospital District Current Accepting new patients
Campbell County Hospital District Current Accepting new patients
Campbell County Hospital District, CurrentSince Jan 1, 2025 Accepting new patients
Campbell County Hospital District CurrentSince Jan 1, 2025 Accepting new patients
University Physicians, Incorporated Past Accepting new patients

Locations

820 W 42nd St
Ste 150
Scottsbluff, NE 69361

820 W 42nd St
Ste 1500
Scottsbluff, NE 69361

1207 E 2nd St
Casper, WY 82601

419 S Washington St
Ste 101
Casper, WY 82601
Phone (307) 232-5037

6600 E 2nd St
Ste E
Casper, WY 82609
Phone (307) 232-5012

501 S Burma Ave
Gillette, WY 82716
Phone (307) 682-8811

Interoperability endpoints

  • Direct secure messaging: eric.cubin@direct.wyomingmedicalcenter.org
  • Direct secure messaging: frederick.cubin.1@29134.direct.athenahealth.com

Organizations & group practices 7

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 7

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1457301004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 S WASHINGTON ST",
            "address_2": "SUITE 101",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012951",
            "telephone_number": "307-265-1620",
            "fax_number": "307-237-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 S WASHINGTON ST",
            "address_2": "SUITE 101",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012951",
            "telephone_number": "307-265-1620",
            "fax_number": "307-237-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUBIN",
        "first_name": "FREDERICK",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WY",
            "license": "8400A",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WY",
            "license": "8400-A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.