Individual provider Active NPI

Diane Marie Kubinski

  • Specialist
  • Medford, NY
National Provider Identifier
1548819303
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1288577191 Issued in NY
Practice address
1 Scouting Blvd
Medford, NY 11763-2220
Phone
(631) 297-3202
NPI assigned
Sep 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1288577191 NY Primary

Addresses

Primary practice location

1 Scouting Blvd
Medford, NY 11763-2220

Mailing address

1 Scouting Blvd
Medford, NY 11763-2220
Phone (631) 297-3202

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

State licenses

LicenseStateTypeSpecialty
1288577191NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1548819303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SCOUTING BLVD",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632220",
            "telephone_number": "631-297-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SCOUTING BLVD",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632220",
            "telephone_number": "631-297-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBINSKI",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1288577191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.