Thane Alexander Luke Kubik, MD, MS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

73228 Issued in MN

Practice address

420 Delaware St SE
Minneapolis, MN 55455-0341

Phone

(612) 624-8133

NPI assigned

Jul 31, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

Interoperability endpoints

• Direct secure messaging: tkubik1950736@ehrdirect.mayoclinicmsg.org

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1669153896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MMC 609, MAYO D142",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-624-8133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341",
            "telephone_number": "612-624-8133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBIK",
        "first_name": "THANE",
        "middle_name": "ALEXANDER LUKE",
        "name_prefix": "Dr.",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-31",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": "73228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkubik1950736@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559050001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Julie Kuberski, OTR/L
• Laurie Frances Kubes, NP
• Paul T Kubic, M.D.
• Virginia L Kubic, MD
• Anne Therese Kubik, LADC
• Carissa Kay Kubitschek
• Allison Kubly, P.T.
• David Kucera
• Sai Kiran Kuchana, MD,MS
• Annika Kuchar

• Student in an Organized Health Care Education/Training Program in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Student in an Organized Health Care Education/Training Program in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.