Individual provider Active NPI

Micaela Grace Kube, PA

  • Physician Assistant
  • New York, NY
National Provider Identifier
1497425904
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
027198 Issued in NY
Practice address
65 Broadway Ste 1800
New York, NY 10006-2549
Phone
(646) 665-3634
NPI assigned
Sep 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1185508 PA
Physician Assistant 363A00000X 25MP00629400 NJ
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X 027198 NY Primary

Addresses

Primary practice location

65 Broadway Ste 1800
New York, NY 10006-2549

Mailing address

2701 Queens PLZ N
Long Island City, NY 11101-4020
Phone (122) 283-3000

Other practice location 1

2 Hudson Pl Ste 101
Hoboken, NJ 07030-5515
Phone (201) 795-0021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20220414000216 NJ Practitioner - Physician Assistant 5294126009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Schweiger Dermatology PCGroup PAC ID 0143442806, 180 clinicians

Practice addresses (Care Compare)

1000 Route 35
Suite 200
Middletown, NJ 07748-2609
Phone (212) 283-3000

2 Hudson PL
Hoboken, NJ 07030-5594
Phone (212) 283-3000

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
027198NYMDPeriodontist
1185508PAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: micaela.kube@schweigerderm.emadirect.md

Organizations & group practices 1

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": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1497425904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 QUEENS PLZ N",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111014020",
            "telephone_number": "122-283-3000",
            "fax_number": "646-665-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 BROADWAY STE 1800",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100062549",
            "telephone_number": "646-665-3634"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Hudson Pl Ste 101",
            "address_purpose": "LOCATION",
            "city": "Hoboken",
            "state": "NJ",
            "postal_code": "070305515",
            "country_code": "US",
            "telephone_number": "201-795-0021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUBE",
        "first_name": "MICAELA",
        "middle_name": "GRACE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "1185508",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00629400",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.