Individual provider Active NPI

Kevin L Kubly, PA-C

  • Physician Assistant
  • Madison, WI
National Provider Identifier
1477523884
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8833-23 Issued in WI
Practice address
1821 S Stoughton Rd
Madison, WI 53716-2257
Phone
(608) 260-6000
Fax
(608) 252-8283
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8833-23 WI Primary
Obesity Medicine (Preventive Medicine) Physician 2083B0002X PADA978 AK

Addresses

Primary practice location

1821 S Stoughton Rd
Madison, WI 53716-2257

Mailing address

3300 Fairbanks St Ste a
Anchorage, AK 99503-4165
Phone (907) 561-3488

Other practice location 1

3300 Fairbanks St Ste A
Anchorage, AK 99503-4165
Phone (907) 561-3488

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address kkubly573427@direct-ehr-ssmhc.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260415000842 WI Practitioner - Physician Assistant 0042514879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

1821 S Stoughton Rd
Madison, WI 53716-2257
Phone (608) 260-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PADA978AKMDObesity Medicine (Preventive Medicine) Physician
8833-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MD Inc CurrentSince Jun 23, 2025 Accepting new patients

Locations

3300 Fairbanks St
Ste A
Anchorage, AK 99503
Phone (907) 561-3488

3300 Artic Blvd
Ste 101
Anchorage, AK 99503
Phone (907) 561-3488

Interoperability endpoints

  • Direct secure messaging: kkubly573427@direct-ehr-ssmhc.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1477523884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 FAIRBANKS ST STE A",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995034165",
            "telephone_number": "907-561-3488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 S STOUGHTON RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537162257",
            "telephone_number": "608-260-6000",
            "fax_number": "608-252-8283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Fairbanks St Ste A",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995034165",
            "country_code": "US",
            "telephone_number": "907-561-3488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUBLY",
        "first_name": "KEVIN",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "8833-23",
            "primary": true
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "AK",
            "license": "PADA978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1821 S Stoughton Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537162257",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkubly573427@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kkubly573427@direct-ehr-ssmhc.com",
            "address_1": "1821 S Stoughton Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537162257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.