Individual provider Active NPI

David T. Dube', P.A.

  • Physician Assistant
  • Edmond, OK
National Provider Identifier
1578679684
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
925 Issued in OK
Practice address
15112 Traditions Blvd Ste a
Edmond, OK 73013-1182
Phone
(405) 289-0483
Fax
(405) 266-6609
NPI assigned
Aug 22, 2006
Last updated
Apr 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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 925 OK Primary

Addresses

Primary practice location

15112 Traditions Blvd Ste a
Edmond, OK 73013-1182

Mailing address

15112 Traditions Blvd Ste a
Edmond, OK 73013-1182
Phone (405) 289-0483

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Geriatric Associates, LLCGroup PAC ID 9537561147, 2 clinicians

Practice addresses (Care Compare)

15112 Traditions Blvd
Suite a
Edmond, OK 73013-1182
Phone (405) 289-0483

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ms Center of Oklahoma LLC Physician Assistant Past Accepting new patients
Kingfisher Regional Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ccfgroup.daviddube@162329.advancedmd-direct.com

Organizations & group practices 3

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1578679684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15112 TRADITIONS BLVD STE A",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131182",
            "telephone_number": "405-289-0483",
            "fax_number": "405-266-6609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15112 TRADITIONS BLVD STE A",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131182",
            "telephone_number": "405-289-0483",
            "fax_number": "405-266-6609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBE'",
        "first_name": "DAVID",
        "middle_name": "T.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.