Individual provider Active NPI

Heidi Kubit, CPNP

  • Pediatric Nurse Practitioner
  • Bay Shore, NY
National Provider Identifier
1548673221
Registry record updated Jun 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
382414 Issued in NY
Practice address
375 E Main St Ste 7
Bay Shore, NY 11706-8418
Phone
(631) 666-6780
NPI assigned
Jun 10, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 382414 NY Primary

Addresses

Primary practice location

375 E Main St Ste 7
Bay Shore, NY 11706-8418

Mailing address

375 E Main St Ste 7
Bay Shore, NY 11706-8418
Phone (631) 666-6780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
382414NYMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1548673221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 E MAIN ST STE 7",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068418",
            "telephone_number": "631-666-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 E MAIN ST STE 7",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068418",
            "telephone_number": "631-666-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBIT",
        "first_name": "HEIDI",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "382414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.