Individual provider Active NPI

Marsha Ann Kubica, OD

  • Optometrist
  • Omaha, NE
National Provider Identifier
1477635175
Registry record updated Aug 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NE 1024 Issued in NE
Practice address
14607 W Center Rd
Omaha, NE 68144-3219
Phone
(402) 330-3000
Fax
(402) 330-3000
NPI assigned
Oct 20, 2006
Last updated
Aug 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NE 1024 NE Primary

Addresses

Primary practice location

14607 W Center Rd
Omaha, NE 68144-3219

Mailing address

14607 W Center Rd
Omaha, NE 68144-3219
Phone (402) 330-3000

Other identifiers 1

IdentifierTypeStateIssuer
47080843713MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110705000146 NE Practitioner - Optometry 8426026436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Omaha Primary Eye Care, P.C.Group PAC ID 1456329465, 4 clinicians

Practice addresses (Care Compare)

1011 S 180TH St
Elkhorn, NE 68022-7044
Phone (402) 330-3000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NE 1024NEMDOptometrist
1024NEMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Omaha Primary Eye Care, P.C. Optometrist CurrentSince Jun 4, 1999 Accepting new patients
Omaha Eyecare Optometrist Past Accepting new patients

Locations

1011 S 180th St
Elkhorn, NE 68022
Phone (402) 330-3000

14607 W Center Rd
Omaha, NE 68144
Phone (402) 330-3000

Interoperability endpoints

  • Direct secure messaging: drkubica@direct.revolutionehr.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, 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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1477635175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14607 W CENTER RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681443219",
            "telephone_number": "402-330-3000",
            "fax_number": "402-330-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14607 W CENTER RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681443219",
            "telephone_number": "402-330-3000",
            "fax_number": "402-330-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBICA",
        "first_name": "MARSHA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "NE 1024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47080843713",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.