Individual provider Active NPI

Bradley Cubitt, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Irving, TX
National Provider Identifier
1457670267
Registry record updated May 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
4301 096 093 Issued in MI
Practice address
701 Tuscan Dr Ste 235
Irving, TX 75039-3839
Phone
(865) 567-2633
NPI assigned
May 19, 2010
Last updated
May 8, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4301 096 093 MI Primary

Addresses

Primary practice location

701 Tuscan Dr Ste 235
Irving, TX 75039-3839

Mailing address

701 Tuscan Dr Ste 235
Irving, TX 75039-3839
Phone (865) 567-2633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180228000221 TX Practitioner - Physical Medicine and RehabilitationPractitioner - Sports Medicine 8628295094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Sports Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

701 Tuscan Dr
Suite 235
Irving, TX 75039-3839
Phone (865) 567-2633

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301 096 093MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Rehabilitation PA Physical Medicine & Rehabilitation Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1457670267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 TUSCAN DR STE 235",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750393839",
            "telephone_number": "865-567-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 TUSCAN DR STE 235",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750393839",
            "telephone_number": "865-567-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUBITT",
        "first_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-19",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301 096 093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.