Individual provider Active NPI

Michelle Kubik, PA-C

  • Physician Assistant
  • Urbandale, IA
National Provider Identifier
1518337393
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
079256 Issued in IA
Practice address
2901 86TH St
Urbandale, IA 50322-4201
Phone
(515) 276-3406
NPI assigned
Oct 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 079256 IA Primary

Addresses

Primary practice location

2901 86TH St
Urbandale, IA 50322-4201

Mailing address

16435 Dellwood Dr
Clive, IA 50325-2576
Phone (515) 205-0020

Other names 1

  • Michelle Ness Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2026 through Jan 1, 2028

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1518337393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16435 DELLWOOD DR",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503252576",
            "telephone_number": "515-205-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 86TH ST",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503224201",
            "telephone_number": "515-276-3406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBIK",
        "first_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "079256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "NESS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Urbandale, IA

Sources for this page

Verify at the official NPI Registry.